Evidence mapPaperPMID 41158424Full record

ArticleMaternal-fetal medicine (Wolters Kluwer Health, Inc.)2025

Dissecting Vasopressor Efficacy in the Management of Maternal Hypotension in Preeclamptic Cesarean Delivery: A Systematic Review of Randomized Controlled Trials.

Made Favian Budi Gunawan, Cindy Thiovany Soetomo, Richard Richard, Putu Bagus Darmayasa, Arresta Vitasatria Suastika

Abstract read
In one paragraph

Article in Maternal-fetal medicine (Wolters Kluwer Health, Inc.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Made Favian Budi GunawanFaculty of Medicine, Universitas Udayana, Denpasar, Bali 80234, Indonesia.
Cindy Thiovany SoetomoFaculty of Medicine, Universitas Udayana, Denpasar, Bali 80234, Indonesia.
Richard RichardFaculty of Medicine, Universitas Udayana, Denpasar, Bali 80234, Indonesia.
Putu Bagus DarmayasaDepartment of Obstetrics and Gynecology, Universitas Udayana, Denpasar, Bali 80234, Indonesia.
Arresta Vitasatria SuastikaDepartment of Obstetrics and Gynecology, Bali International Hospital, Denpasar, Bali 80227, Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To evaluate the safety and effectiveness of intermittent bolus administration of ephedrine, norepinephrine, and phenylephrine in the treatment of maternal hypotension during spinal anesthesia for cesarean sections in preeclamptic women. Methods: This PRISMA-based systematic review included English random control trails (RCTs) of women with singleton preeclampsia (American College of Obstetricians and Gynecologists (ACOG) criteria) undergoing cesarean delivery with spinal anesthesia, excluding chronic hypertension or systemic disease. Interventions were intermittent bolus phenylephrine, norepinephrine, or ephedrine, with outcomes on maternal hemodynamics, neonatal status, and adverse events. Searches of PubMed, ScienceDirect, Google Scholar, and Cochrane (to December 2024) plus reference screening identified eligible studies. Two reviewers independently selected studies, extracted data, and assessed risk of bias (Cochrane RoB 2.0). Due to heterogeneity in vasopressor regimens and outcome measures, results were synthesized narratively. Results: Of 2333 records screened, six RCTs (sample sizes 20-166) were included, all in preeclamptic women undergoing cesarean delivery. Overall risk of bias was low. Norepinephrine better preserved maternal hemodynamics than phenylephrine or ephedrine, with higher cardiac output (6.31 ± 1.08 Conclusion: Intermittent bolus administration of norepinephrine offers superior maternal cardiac output and neonatal safety, making it optimal for preeclamptic cesarean deliveries. Phenylephrine is effective for blood pressure control but may induce bradycardia, while the use of ephedrine is limited by its association with neonatal acidosis. Tailored vasopressor selection is thus essential for optimal outcomes. Registration: PROSPERO; CRD42024565007.

Indexed as

Cesarean sectionIntermittent bolus vasopressorsMaternal hypotensionPreeclampsiaPregnancy

Identifiers

PMID41158424
PMCPMC12558338

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.