Effect on neonatal outcomes of maintenance of maternal blood pressure targets with noradrenaline after spinal anaesthesia for caesarean delivery: a multicentre, randomised, controlled trial
Authors' conclusion
During caesarean delivery under spinal anaesthesia, maintaining maternal systolic blood pressure > 90% of baseline, compared with > 80% of baseline, with boluses of noradrenaline reduces the incidence of neonatal acidaemia, maternal hypotension and nausea and vomiting.
Study context
- Population
- Women with term pregnancies undergoing caesarean delivery under spinal anaesthesia1,183 analysed
- Participants
- 590 vs 593
- Comparison
- SBP-90% vs SBP-80%
- SBP-90%n = 590
- SBP-80%n = 593reference
- Primary endpoint
- Umbilical artery pH
Methodological detailsmulticentre
- Multicentre
Primary result
As reported in the abstract
SBP-90%
7.33
mean · SD 0.04
SBP-80%
7.33
mean · SD 0.05
P = 0.11
Secondary outcomes
Umbilical artery pH < 7.2
P = 0.020
Median
| Outcome | SBP-90% | SBP-80% | P value |
|---|---|---|---|
| Noradrenaline boluses | 2 (IQR [range] 1-3 [0-14]) | 1 (IQR [range] 0-2 [0-14]) | P < 0.001 |
Safety
Maternal hypotension (< 80% of baseline systolic)
P < 0.001
Severe hypotension (< 60% of baseline systolic)
P = 0.006
Nausea and vomiting
P < 0.001
Original publication
Effect on neonatal outcomes of maintenance of maternal blood pressure targets with noradrenaline after spinal anaesthesia for caesarean delivery: a multicentre, randomised, controlled trial. Anaesthesia. Published 26 February 2026. doi:10.
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