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Background <p>Prophylaxis of norepinephrine (NE) at a constant rate has been demonstrated to be as efficacious as prophylaxis of phenylephrine (PE) at equivalent doses for the prevention of maternal hypotension during cesarean section. Nevertheless, the impact of prophylactic infusion of NE or PE at a constant rate on pregnant women on fetal outcomes remains to be elucidated.</p> Methods <p>90 women scheduled for caesarean section under spinal or combined spinal–epidural anesthesia were randomly assigned to either the NE or PE group. The “study drug” (NE or PE) was administered intravenously at a rate of 15&#xa0;mL/h from the time of injection of subarachnoid solution until the time of delivery of the fetus. Fetal umbilical artery (UA) blood was collected for blood gas analysis. The primary outcome of the study was base excess, and the incidence of fetal acidosis (Defined as base excess &lt; 6&#xa0;mmol/l) and blood glucose levels were also assessed.</p> Results <p>The UA base excess mean (standard deviation) was not different from the NE group, − 1.6 (2.6) versus − 2.4 (2.9) in the PE group (<i>P</i> = 0.223). The incidence of fetal acidosis was 4.7% (NE) versus 14.3% (PE), with no statistically significant difference (<i>P</i> = 0.308). However, fetal blood glucose levels were significantly lower in the NE group, 3.16 (0.43) versus 3.43 (0.60) in the PE group (<i>P</i> = 0.019).</p> Conclusions <p>Prophylactic infusion of equivalent doses of NE at a constant rate resulted in fetal base excess values and an incidence of acidosis comparable to that of PE. However, a lower fetal UA blood glucose value was observed in the NE group, a finding that warrants further investigation.</p>

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Effects of prophylactic constant-rate infusion of norepinephrine or phenylephrine on neonatal outcomes during caesarean section

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月4日

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  • Wenhui Tao,
  • Jinfeng Bao,
  • Qing Wang,
  • Yufang Xie,
  • Shun Li,
  • Zicheng Wang,
  • Shoufeng Zhu,
  • Linghui Huang,
  • Yan Yang,
  • Xun Xu,
  • Pengcheng Zhu,
  • Panpan Ding,
  • Jieli Tian,
  • Xiaofen Liu,
  • Haifeng Cao,
  • Wei Liu,
  • Shuwen He,
  • Wensheng He,
  • Ye Zhang,
  • Xianwen Hu

摘要

Background

Prophylaxis of norepinephrine (NE) at a constant rate has been demonstrated to be as efficacious as prophylaxis of phenylephrine (PE) at equivalent doses for the prevention of maternal hypotension during cesarean section. Nevertheless, the impact of prophylactic infusion of NE or PE at a constant rate on pregnant women on fetal outcomes remains to be elucidated.

Methods

90 women scheduled for caesarean section under spinal or combined spinal–epidural anesthesia were randomly assigned to either the NE or PE group. The “study drug” (NE or PE) was administered intravenously at a rate of 15 mL/h from the time of injection of subarachnoid solution until the time of delivery of the fetus. Fetal umbilical artery (UA) blood was collected for blood gas analysis. The primary outcome of the study was base excess, and the incidence of fetal acidosis (Defined as base excess < 6 mmol/l) and blood glucose levels were also assessed.

Results

The UA base excess mean (standard deviation) was not different from the NE group, − 1.6 (2.6) versus − 2.4 (2.9) in the PE group (P = 0.223). The incidence of fetal acidosis was 4.7% (NE) versus 14.3% (PE), with no statistically significant difference (P = 0.308). However, fetal blood glucose levels were significantly lower in the NE group, 3.16 (0.43) versus 3.43 (0.60) in the PE group (P = 0.019).

Conclusions

Prophylactic infusion of equivalent doses of NE at a constant rate resulted in fetal base excess values and an incidence of acidosis comparable to that of PE. However, a lower fetal UA blood glucose value was observed in the NE group, a finding that warrants further investigation.