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Published on: November 21, 2017
Effect of Active Rewarming on Normothermia, Maternal and Neonatal Outcomes in Elective Cesarean Section: A Randomized
Sinem Öztürkler1, Yasemin Özhanlı2, Aycan Şahin3
1Department of Pediatric Nursing, Faculty of Health Sciences, Kocaeli University, Kocaeli, Turkey.
Purpose:
Maintenance of normothermia during the perioperative period in Cesarean section operations is critical for both maternal and neonatal health and the adaptation of the newborn to the external environment. The aim of this study was to evaluate the efficacy of active warming during elective Cesarean section for maintaining normothermia and its effects on maternal and neonatal health.
Design:
A single-blind, randomized controlled study enrolled women and their infants admitted to a hospital for elective Cesarean section.
Methods:
The study was conducted in two arms with an active heating and control group. A heating device was placed on the pregnant woman's back 30 min before Cesarean section and the heating process continued for 30 min after delivery. Data were collected using a personal information form, follow-up form (vital signs, neonatal cortisol level, APGAR score), Spielberger State Anxiety Inventory and Thermal Comfort Scale. Measurements were performed 30 min before, during and 30 min after Cesarean section. The data obtained were analyzed with a 95% confidence interval.
Findings:
A total of 51 women were recruited with 26 (51%) in the intervention group and 25 (49%) in the control group. While the body temperatures of both groups were similar at the first measurement, the intervention group maintained temperature at the last measurement (p=0.039) while hypothermia was detected in the control group (p<0.001). At the last measurement, 3.8% of the intervention group were shivering but, all of the control group was shivering. Body temperature of newborns was 36.2°C in the intervention group and 36.0°C in the control group ((p<0.001). APGAR score was 8.5 at 1 min and 9.7 at 5 min in the intervention group and 7.9 and 9.2 in the control group, respectively. Serum cortisol and glucose results were similar in both groups.
Conclusion:
By maintaining normothermia with, active warming starting before Cesarean section and continuing active warming up to half an hour after delivery affected maternal vital signs, chills, shivering, thermal comfort and anxiety states. In addition, body temperature and APGAR score of newborns increased, while cortisol and glucose levels were not affected.
Clinical Trial Number:
NCT06962241.
