Introduction
According to the Curley’s definition the normothermia
corresponds to a core temperature between 36,6°C ± 0,38°C.
Mild hypothermia can cause cardiovascular, hematological,
metabolic and hormonal alterations.
Maternal hypothermia is common during cesarean delivery and it
can exercise influence over neonatal temperature, umbilical
acidosis and lower Apgar score at birth.
A prospective randomized trial of healthy term parturients
undergoing cesarean delivery was designed to assess the
incidence of hypothermia and the impact of active warming on
maternal and neonatal outcomes.
Materials and Methods
Sixty-seven healthy women undergoing cesarean delivery with
spinal anesthesia were randomly assigned to receive either
warmed IV fluid and lower body forced-air warmer (AW) or no
warming, IV fluid infused at environmental temperature (NW).
A forehead zero-heat-flux sensor was used to measure core
temperature at baseline and every ten minutes intraoperatively
until the operating room exit. Neonatal axillary temperature was
also measured.
Perioperative shivering (Bedside Shivering Assessment Scale: 0-
3), thermal comfort scores ( TCS: 0- 100 scale), Apgar scores,
and umbilical cord blood gas analysis were recorded.
Results and Discussion
The baseline data were similar between the two groups. The AW
group (32 patients) had a higher temperature compared with the
NW group (35 patients) at the operating room exit (36,7°C ±
0,32°C vs 36,28°C ± 0,35°C; p< 0,001). In four NW patients the
temperature significantly decreased from 30 minutes after
neuraxial anesthesia until the operating room exit (30 min vs
baseline: 35,62°C ± 0,20°C vs 36,75°C ± 0,13°C; p< 0,001).
These patients experienced also shivering (2 score). The TCS
was higher in AW vs NW group during the study period (at 30
min: p< 0,001).
Neonatal hypothermia was observed in twenty (57%) newborns
of the NW group. The Apgar scores and the umbilical cord blood
gas analysis were similar between groups.
Conclusions
The Active warming utilizing combined IV fluid and forced-air
warming is effective in decreasing the incidence of maternal and
neonatal hypothermia as well as maternal shivering during
cesarean delivery.
Therefore the maternal comfort and the neonatal outcome are
improved.

02 / Evaluation of the active warming effects on maternal and neonatal outcomes during cesarean delivery