[Risk factors for post-caesarean nausea and vomiting: a prospective prognostic study]

Area of Science:

• Obstetrics
• Anesthesiology
• Clinical Pharmacology

Background:

• Risk factors for Postoperative Nausea and Vomiting (PONV) remain undefined in obstetric patients.
• Cesarean sections under spinal anesthesia present unique challenges for PONV management.

Purpose of the Study:

• To identify potential risk factors for PONV in patients undergoing cesarean sections.
• To elucidate predictors of PONV in this specific obstetric population.

Main Methods:

• A cohort study design was employed to investigate PONV risk factors.
• Statistical methods including chi-squared and causal network analysis were used to identify significant predictors.
• Numerical risk factors were dichotomized for analysis.

Main Results:

• Younger maternal age (< 25 years), lower spinal bupivacaine/morphine doses, motion sickness history, and intraoperative nausea were significant risk factors.
• Absence of first-trimester nausea and lower gestational age (< 38 weeks) were also significant.
• Causal network analysis identified absence of first-trimester nausea, intraoperative nausea, and gestational age < 38 weeks as primary direct risk factors.

Conclusions:

• Intraoperative nausea and maternal age under 25 are primary risk factors for PONV post-cesarean.
• Absence of nausea during the first trimester acts as a protective factor against PONV.