Date of Publication

4-2025

Document Type

Bachelor's Thesis

Degree Name

Bachelor of Science in Biology major in Medical Biology

Subject Categories

Medicine and Health Sciences

College

College of Science

Department/Unit

Biology

Thesis Advisor

Jowi Tsidkenu P. Cruz

Defense Panel Chair

Michael B. Ples

Defense Panel Member

Ralph Ronnel R. Rebello
Amador F. Simando III

Abstract/Summary

Post-spinal anesthesia hypotension during cesarean delivery poses significant risks to maternal cardiac output and fetal oxygenation. Although phenylephrine (PE) is the standard vasopressor, its use is linked to an increased incidence of maternal bradycardia. In contrast, norepinephrine (NE) offers a more favorable hemodynamic profile and is emerging as a promising alternative. This systematic review and meta-analysis of 18 randomized controlled trials compared NE and PE for the prevention and treatment of post-spinal hypotension in cesarean section parturients. Our findings demonstrate that while NE and PE are equally effective in managing hypotension, NE significantly reduces the incidence of maternal bradycardia (OR = 0.49 [CI: 0.38 to 0.62]) and shows a trend toward fewer adverse maternal events, such as dizziness and reactive hypertension. Additionally, neonatal outcomes indicated a lower birth weight with NE—although still within the normal range— along with tendencies toward lower umbilical arterial lactate levels and improved umbilical vein blood gas pH. These results support NE as a viable alternative to PE, particularly for lowering the incidence of maternal bradycardia, and provide crucial evidence for updating clinical practice guidelines to enhance maternal and neonatal care during cesarean deliveries.

Abstract Format

html

Language

English

Format

Electronic

Keywords

Cesarean section—Complications; Spinal anesthesia; Norepinephrine; Hypertension in pregnancy

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Embargo Period

4-12-2026

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Available for download on Sunday, April 12, 2026

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