Observational studyBMC pregnancy and childbirth2025
Effectiveness of lumbar wedge in preventing intraoperative hypotension during cesarean delivery in multiple gestation: a retrospective analysis.
Observational study in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSupine hypotension syndrome, caused by aortocaval compression of the gravid uterus in the supine position, is a common concern during cesarean delivery, particularly in women with multiple gestations. This retrospective study aimed to determine whether the use of a lumbar wedge reduces intraoperative hypotension in women with multiple gestations undergoing cesarean delivery under spinal anesthesia.
methodsA total of 199 women with multiple gestations who underwent cesarean delivery under spinal anesthesia were included. Participants were divided into two groups based on lumbar wedge application: wedge (n = 108) and horizontal (n = 91). The primary outcome was the incidence of intraoperative hypotension, defined as the need for vasopressors (phenylephrine or ephedrine) at least once during surgery. Secondary outcomes included the total administered vasopressor dose and neonatal outcomes.
resultsThe incidence of intraoperative hypotension was significantly lower in the wedge group than in the horizontal group (70.4% vs. 86.8%; P = 0.005; RR, 0.8; 95% CI, 0.7 to 0.9). Phenylephrine requirements were significantly lower in the wedge group than in the horizontal group (4.0 ± 5.7 vs. 7.0 ± 7.7 µg/min; mean difference, -3.0; 95% CI, -4.9 to -1.1; P = 0.002), as were ephedrine requirements (0.04 ± 0.07 vs. 0.10 ± 0.13 mg/min; mean difference, -0.06; 95% CI, -0.09 to -0.03; P < 0.001). Neonatal cord blood gas values were within normal ranges, although some parameters differed significantly between groups. Specifically, the PCO2 levels of the first and third infants (P = 0.024 and 0.025, respectively), and the HCO3− and base excess values of the second infant (P = 0.025 and 0.011, respectively), differed significantly between the wedge and horizontal groups.
conclusionThe use of a lumbar wedge in patients with multiple gestations was associated with a significant reduction in the incidence of intraoperative hypotension during cesarean delivery under spinal anesthesia. These findings suggest that lumbar wedge positioning may be a simple, low-cost, and easily applicable technique to potentially enhance maternal hemodynamic stability and improve perioperative safety in multiple gestation pregnancies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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 OpenQuestion graph.