Effect on neonatal outcomes of maintenance of maternal blood pressure targets with noradrenaline after spinal anaesthesia for caesarean delivery: a multicentre, randomised, controlled trial

Hypotension after spinal anaesthesia for caesarean delivery can cause maternal and neonatal harm. However, excessive vasopressor therapy may also result in harm, and the optimal blood pressure target is unclear. We compared two different maternal blood pressure targets during caesarean delivery.

Women with term pregnancies undergoing caesarean delivery under spinal anaesthesia were assigned randomly to maintenance of systolic blood pressure within 90% (SBP-90% group) or 80% (SBP-80% group) of baseline readings, from intrathecal injection until delivery. The primary outcome was umbilical artery pH. Secondary outcomes included incidence of umbilical artery pH 90% of baseline, compared with > 80% of baseline, with boluses of noradrenaline reduces the incidence of neonatal acidaemia, maternal hypotension and nausea and vomiting.