Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis
<h3>Objective</h3><p dir="ltr">We conducted a systematic review and meta-analysis to evaluate the fetomaternal outcomes after the administration of norepinephrine or phenylephrine for the treatment of post spinal hypotension in preeclamptic women undergoing a cesarean sec...
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2024
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| _version_ | 1864513554981322752 |
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| author | Shahzaib Ahmed (11627215) |
| author2 | Eeman Ahmad (20151408) Eeshal Fatima (18255772) Umar Akram (20151411) Obaid Ur Rehman (20151414) Arya Harikrishna (20151417) Shaiza Sharif (20151420) Noreen Akmal (20151423) Abdulqadir J. Nashwan (11659453) |
| author2_role | author author author author author author author author |
| author_facet | Shahzaib Ahmed (11627215) Eeman Ahmad (20151408) Eeshal Fatima (18255772) Umar Akram (20151411) Obaid Ur Rehman (20151414) Arya Harikrishna (20151417) Shaiza Sharif (20151420) Noreen Akmal (20151423) Abdulqadir J. Nashwan (11659453) |
| author_role | author |
| dc.creator.none.fl_str_mv | Shahzaib Ahmed (11627215) Eeman Ahmad (20151408) Eeshal Fatima (18255772) Umar Akram (20151411) Obaid Ur Rehman (20151414) Arya Harikrishna (20151417) Shaiza Sharif (20151420) Noreen Akmal (20151423) Abdulqadir J. Nashwan (11659453) |
| dc.date.none.fl_str_mv | 2024-12-01T00:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1016/j.ejogrb.2024.10.012 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Efficacy_and_safety_of_norepinephrine_versus_phenylephrine_for_post-spinal_hypotension_in_preeclamptic_patients_A_systematic_review_and_meta-analysis/27643098 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Reproductive medicine Preeclampsia Hypotension Norepinephrine Phenylephrine |
| dc.title.none.fl_str_mv | Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Objective</h3><p dir="ltr">We conducted a systematic review and meta-analysis to evaluate the fetomaternal outcomes after the administration of norepinephrine or phenylephrine for the treatment of post spinal hypotension in preeclamptic women undergoing a cesarean section.</p><h3>Data sources</h3><p dir="ltr">We searched on PubMed, Embase, Scopus, Cochrane CENTRAL, and clinicaltrials.gov from inception till June 2024.</p><h3>Study selection</h3><p dir="ltr">Randomized controlled trials of preeclamptic women receiving norepinephrine or phenylephrine for post spinal hypotension were included.</p><h3>Data extraction and synthesis</h3><p dir="ltr">Two reviewers extracted data onto an Excel spreadsheet. R version 4.4 was used for statistical analysis. Risk ratios (RR) and their 95% confidence intervals (CIs) were calculated and pooled using the random effects model. Cochrane’s risk of bias (RoB 2) tool was used for quality assessment. This review has been registered with PROSPERO (CRD42024532740).</p><h3>Results</h3><p dir="ltr">A total of 4 trials, comprising 413 participants, were included in this review. 206 patients received norepinephrine, while 207 received phenylephrine. The incidence of maternal bradycardia was significantly lower in the norepinephrine group compared with the phenylephrine group (RR = 0.25, 95 % CI = 0.16 to 0.39, p < 0.01). There were no statistical differences in other maternal outcomes or in the umbilical artery and umbilical vein blood gas analysis values. We also analyzed adverse events such as nausea (RR = 1.00, 95 % CI: 0.62 to 1.60, p = 1.00) and vomiting (RR = 0.99, 95 % CI: 0.89 to 1.11, p = 0.61), but they did not show a significant association with any group. All the trials had a moderate or low risk of bias.</p><h3>Conclusion</h3><p dir="ltr">Bolus doses of NE and PE for the treatment of post-spinal hypotension in preeclamptic women undergoing cesarean sections were found to exhibit comparable neonatal outcomes. However, NE provided superior maternal safety due to a lower incidence of bradycardia compared to PE.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Obstetrics & Gynecology and Reproductive Biology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.ejogrb.2024.10.012" target="_blank">https://dx.doi.org/10.1016/j.ejogrb.2024.10.012</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_114b680d51e61f6b2948b024f1d78b23 |
| identifier_str_mv | 10.1016/j.ejogrb.2024.10.012 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/27643098 |
| publishDate | 2024 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysisShahzaib Ahmed (11627215)Eeman Ahmad (20151408)Eeshal Fatima (18255772)Umar Akram (20151411)Obaid Ur Rehman (20151414)Arya Harikrishna (20151417)Shaiza Sharif (20151420)Noreen Akmal (20151423)Abdulqadir J. Nashwan (11659453)Biomedical and clinical sciencesPharmacology and pharmaceutical sciencesReproductive medicinePreeclampsiaHypotensionNorepinephrinePhenylephrine<h3>Objective</h3><p dir="ltr">We conducted a systematic review and meta-analysis to evaluate the fetomaternal outcomes after the administration of norepinephrine or phenylephrine for the treatment of post spinal hypotension in preeclamptic women undergoing a cesarean section.</p><h3>Data sources</h3><p dir="ltr">We searched on PubMed, Embase, Scopus, Cochrane CENTRAL, and clinicaltrials.gov from inception till June 2024.</p><h3>Study selection</h3><p dir="ltr">Randomized controlled trials of preeclamptic women receiving norepinephrine or phenylephrine for post spinal hypotension were included.</p><h3>Data extraction and synthesis</h3><p dir="ltr">Two reviewers extracted data onto an Excel spreadsheet. R version 4.4 was used for statistical analysis. Risk ratios (RR) and their 95% confidence intervals (CIs) were calculated and pooled using the random effects model. Cochrane’s risk of bias (RoB 2) tool was used for quality assessment. This review has been registered with PROSPERO (CRD42024532740).</p><h3>Results</h3><p dir="ltr">A total of 4 trials, comprising 413 participants, were included in this review. 206 patients received norepinephrine, while 207 received phenylephrine. The incidence of maternal bradycardia was significantly lower in the norepinephrine group compared with the phenylephrine group (RR = 0.25, 95 % CI = 0.16 to 0.39, p < 0.01). There were no statistical differences in other maternal outcomes or in the umbilical artery and umbilical vein blood gas analysis values. We also analyzed adverse events such as nausea (RR = 1.00, 95 % CI: 0.62 to 1.60, p = 1.00) and vomiting (RR = 0.99, 95 % CI: 0.89 to 1.11, p = 0.61), but they did not show a significant association with any group. All the trials had a moderate or low risk of bias.</p><h3>Conclusion</h3><p dir="ltr">Bolus doses of NE and PE for the treatment of post-spinal hypotension in preeclamptic women undergoing cesarean sections were found to exhibit comparable neonatal outcomes. However, NE provided superior maternal safety due to a lower incidence of bradycardia compared to PE.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Obstetrics & Gynecology and Reproductive Biology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.ejogrb.2024.10.012" target="_blank">https://dx.doi.org/10.1016/j.ejogrb.2024.10.012</a></p>2024-12-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.ejogrb.2024.10.012https://figshare.com/articles/journal_contribution/Efficacy_and_safety_of_norepinephrine_versus_phenylephrine_for_post-spinal_hypotension_in_preeclamptic_patients_A_systematic_review_and_meta-analysis/27643098CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/276430982024-12-01T00:00:00Z |
| spellingShingle | Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis Shahzaib Ahmed (11627215) Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Reproductive medicine Preeclampsia Hypotension Norepinephrine Phenylephrine |
| status_str | publishedVersion |
| title | Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis |
| title_full | Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis |
| title_short | Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis |
| title_sort | Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis |
| topic | Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Reproductive medicine Preeclampsia Hypotension Norepinephrine Phenylephrine |