Book

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This book summarized Neonatal outcome following norepinephrine versus phenylephrine for treatment of spinal-induced hypotension among women undergoing cesarean section: systematic review and meta-analysis of randomized controlled trials Introduction Spinal-induced hypotension is defined as reduced blood pressure more than three-fourths from baseline or a drop of systolic blood pressure up to 100 mmHg. Due to sympathetic blocking, which causes vasodilation and increases sensitivity to nerve contractions, the incidence of spinal-induced hypotension is up to 75% with cesarean sections. The consequences of spinal hypotension are a decrease in uterine blood flow, foetal circulation, foetal hypoxia, and maternal bradycardia Phenylephrine is a first-line drug to prevent spinal-induced hypotension, but many studies report its risks for maternal bradycardia, so to decrease the maternal bradycardia, alternative drugs come into practice. This systematic review and meta-analysis aim to explore the effect of phenylephrine or norepinephrine on neonatal outcome following the treatment of spinal-induced hypotension and maternal hemodynamics. Methods The review was reported in the form of a systematic review and meta-analysis (PRISMA) and the appraisal was done according to the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. The systematic review research question starts with (PICO). Participants: pregnant twins and singletons who underwent a cesarean section under spinal anesthesia Interventions: phenylephrine or norepinephrine for the treatment of spinal-induced hypotension Comparator: comparison of the effect of phenylephrine with norepinephrine on neonatal outcome.