The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Barkovskaya N.A.

Privolzhsky Research Medical University, Nizhny Novgorod, Russia;
Dzerzhinsk Perinatal Center, Dzerzhinsk, Russia

Shifman E.M.

Pirogov Russian National Research Medical University, Moscow, Russia

Protsenko D.N.

Pirogov Russian National Research Medical University, Moscow, Russia

Lebedinskii K.M.

Mechnikov North-Western State Medical University, St. Petersburg, Russia;
Federal Research Clinical Center of Intensive Care and Rehabilitation, Moscow, Russia

Katkova N.Yu.

Privolzhsky Research Medical University, Nizhny Novgorod, Russia

Inadvertent hypothermia in obstetric patients: prevention and treatment (a scoping review)

Authors:

Barkovskaya N.A., Shifman E.M., Protsenko D.N., Lebedinskii K.M., Katkova N.Yu.

More about the authors

Read: 795 times


To cite this article:

Barkovskaya NA, Shifman EM, Protsenko DN, Lebedinskii KM, Katkova NYu. Inadvertent hypothermia in obstetric patients: prevention and treatment (a scoping review). Russian Journal of Anesthesiology and Reanimatology. 2026;(2):93‑107. (In Russ., In Engl.)
https://doi.org/10.17116/anaesthesiology202602193

Recommended articles:
Cesa­rean section in modern obstetrics: problems and ways to overcome them. Russian Bulletin of Obstetrician-Gynecologist. 2025;(4):5-18
Features of the stru­cture of uterine scars after cesa­rean section. Russian Journal of Human Reproduction. 2025;(5):75-83
Anesthetic mana­gement of abdo­minal deli­very in pregnant women with morbid obesity. Russian Bulletin of Obstetrician-Gynecologist. 2026;(1):24-32

References:

  1. Manturova NE, Rakhimov AYa, Verbo EV, Kurbanova ZV. Inadvertent perioperative hypothermia in plastic surgery. Plastic Surgery and Aesthetic Medicine. 2025;(1):5-13. (In Russ.). https://doi.org/10.17116/plast.hirurgia20250115
  2. Yokoyama K, Suzuki M, Shimada Y, Matsushima T, Bito H, Sakamoto A. Effect of administration of pre-warmed intravenous fluids on the frequency of hypothermia following spinal anesthesia for Cesarean delivery. Journal of Clinical Anesthesia. 2009;21:242-248.  https://doi.org/10.1016/j.jclinane.2008.12.010
  3. Wang J, Deng X. Inadvertent hypothermia: a prevalent perioperative issue that remains to be improved. Anesthesiology and Perioperative Science. 2023;1:24.  https://doi.org/10.1007/s44254-023-00022-6
  4. Chen W-A, Liu C-C, Mnisi Z, Chen C-Y, Kang Y-N. Warming strategies for preventing hypothermia and shivering during cesarean section: A systematic review with network meta-analysis of randomized clinical trials. International Journal of Surgery. 2019;71:21-28.  https://doi.org/10.1016/j.ijsu.2019.09.006
  5. Peters MD, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Scoping Reviews. JBI Man Evidence Synthesis. 2024. https://doi.org/10.46658/JBIMES-24-09
  6. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunçalp Ö, Straus SE. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine. 2018;169(7):467-473.  https://doi.org/10.7326/M18-0850
  7. Kulakova EN, Nastausheva TL, Kondratyeva IV. Scoping Review Methodology: History, Theory and Practice. Voprosy sovremennoj pediatrii. 2021;20: 210-222. (In Russ.). https://doi.org/10.15690/vsp.v20i3/2271
  8. Klinicheskie rekomendatsii. Rody odnoplodnye, rodorazreshenie putem kesareva secheniya. 2024. (In Russ.). Accessed August 12, 2025. https://cr.minzdrav.gov.ru/recomend/639_2
  9. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Systematic Reviews. 2016;5:210.  https://doi.org/10.1186/s13643-016-0384-4
  10. Zhuo Q, Xu J-B, Zhang J, Ji B. Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trials. BMC Pregnancy Childbirth. 2022;22:720.  https://doi.org/10.1186/s12884-022-05054-7
  11. Sultan P, Habib AS, Cho Y, Carvalho B. The Effect of patient warming during Caesarean delivery on maternal and neonatal outcomes: a meta-analysis. British Journal of Anaesthesia. 2015;115:500-510.  https://doi.org/10.1093/bja/aev325
  12. Munday J, Hines S, Wallace K, Chang AM, Gibbons K, Yates P. A Systematic Review of the Effectiveness of Warming Interventions for Women Undergoing Cesarean Section. Worldviews on Evidence-Based Nursing. 2014;11:383-393.  https://doi.org/10.1111/wvn.12067
  13. Haim S, Cohen B, Lustig A, Greenberger C, Aptekman B, Weiniger CF. Lower-body warming and postoperative temperature in cesarean delivery under spinal anesthesia: a randomized controlled trial. International Journal of Obstetric Anesthesia. 2024;58:103990. https://doi.org/10.1016/j.ijoa.2024.103990
  14. Cobb B, Cho Y, Hilton G, Ting V, Carvalho B. Active Warming Utilizing Combined IV Fluid and Forced-Air Warming Decreases Hypothermia and Improves Maternal Comfort During Cesarean Delivery: A Randomized Control Trial. Anesthesia and Analgesia. 2016;122:1490-1497. https://doi.org/10.1213/ANE.0000000000001181
  15. Duryea EL, Nelson DB, Wyckoff MH, Grant EN, Tao W, Sadana N, Chalak LF, McIntire DD, Leveno KJ. The impact of ambient operating room temperature on neonatal and maternal hypothermia and associated morbidities: a randomized controlled trial. American Journal of Obstetrics and Gynecology. 2016;214:505.e1-505.e7.  https://doi.org/10.1016/j.ajog.2016.01.190
  16. Chakladar A, Dixon MJ, Crook D, Harper CM. The effects of a resistive warming mattress during caesarean section: a randomised, controlled trial. International Journal of Obstetric Anesthesia. 2014;23:309-316.  https://doi.org/10.1016/j.ijoa.2014.06.003
  17. Paris LG, Seitz M, McElroy KG, Regan M. A randomized controlled trial to improve outcomes utilizing various warming techniques during cesarean birth. Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN. 2014;43:719-728.  https://doi.org/10.1111/1552-6909.12510
  18. Chung SH, Lee BS, Yang HJ, Kweon KS, Kim HH, Song J, Shin DW. Effect of preoperative warming during cesarean section under spinal anesthesia. Korean Journal of Anesthesiology 2012;62(5):454.  https://doi.org/10.4097/kjae.2012.62.5.454
  19. Goyal P, Kundra S, Sharma S, Grewal A, Kaul T, Singh MR. Efficacy of intravenous fluid warming for maintenance of core temperature during lower segment cesarean section under spinal anesthesia. Journal of Obstetric Anesthesia and Critical Care. 2011;1:73.  https://doi.org/10.4103/2249-4472.93990
  20. Woolnough M, Allam J, Hemingway C, Cox M, Yentis SM. Intra-operative fluid warming in elective caesarean section: a blinded randomised controlled trial. International Journal of Obstetric Anesthesia. 2009;18:346-351.  https://doi.org/10.1016/j.ijoa.2009.02.009
  21. Butwick AJ, Lipman SS, Carvalho B. Intraoperative Forced Air-Warming During Cesarean Delivery Under Spinal Anesthesia Does Not Prevent Maternal Hypothermia. Anesthesia and Analgesia. 2007;105:1413-1419. https://doi.org/10.1213/01.ane.0000286167.96410.27
  22. Fallis WM, Hamelin K, Symonds J, Wang X. Maternal and newborn outcomes related to maternal warming during cesarean delivery. Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN. 2006;35:324-331.  https://doi.org/10.1111/j.1552-6909.2006.00052.x
  23. Horn E-P, Schroeder F, Gottschalk A, Sessler DI, Hiltmeyer N, Standl T, Schulte am Esch J. Active warming during cesarean delivery. Anesthesia and Analgesia. 2002;94(2):409-414, table of contents. https://doi.org/10.1097/00000539-200202000-00034
  24. Akdag Topal C, Yucel Ozcirpan C, Ozyuncu O. The effect of forced-air warming in the cesarean section on maternal hypothermia, shivering, and thermal comfort: A randomized controlled trial. Health Care for Women International. 2024;45:1016-1033. https://doi.org/10.1080/07399332.2023.2245366
  25. Jørgensen HS, Bach LF, Helbo-Hansen HS, Nielsen PA. Warm or cold saline for volume preload before spinal anaesthesia for caesarean section? International Journal of Obstetric Anesthesia. 2000;9:20-25.  https://doi.org/10.1054/ijoa.1999.0331
  26. Cotoia A, Mariotti PS, Ferialdi C, Del Vecchio P, Beck R, Zaami S, et al. Effectiveness of Combined Strategies for the Prevention of Hypothermia Measured by Noninvasive Zero-Heat Flux Thermometer During Cesarean Section. Frontiers in Medicine. 2021;8:734768. https://doi.org/10.3389/fmed.2021.734768
  27. Yang C, Cheng Y, Liu S, Huang S, Yu X. Effect of Preoperative Oral Carbohydrate Loading on Body Temperature During Combined Spinal-Epidural Anesthesia for Elective Cesarean Delivery. Anesthesia and Analgesia. 2021;133:731-738.  https://doi.org/10.1213/ANE.0000000000005447
  28. Ni T, Zhou Z, He B, Zhou Q. Effects of combined warmed preoperative forced-air and warmed perioperative intravenous fluids on maternal temperature during cesarean section: a prospective, randomized, controlled clinical trial. BMC Anesthesiology. 2020;20:48.  https://doi.org/10.1186/s12871-020-00970-7
  29. Jun J-H, Chung MH, Jun I-J, Kim Y, Kim H, Kim JH, Choi YR, Choi EM. Efficacy of forced-air warming and warmed intravenous fluid for prevention of hypothermia and shivering during caesarean delivery under spinal anaesthesia. European Journal of Anesthesiology. 2019;36(6):442-448.  https://doi.org/10.1097/EJA.0000000000000990
  30. Cantürk M, Cantürk FK, Kocaoğlu N, Hakki M. The effects of crystalloid warming on maternal body temperature and fetal outcomes: a randomized controlled trial. Brazilian Journal of Anesthesiology (English Ediiition). 2019;69:13-19.  https://doi.org/10.1016/j.bjane.2018.09.007
  31. Chebbout R, Newton RS, Walters M, Wrench IJ, Woolnough M. Does the addition of active body warming to in-line intravenous fluid warming prevent maternal hypothermia during elective caesarean section? A randomised controlled trial. International Journal of Obstetric Anesthesia. 2017;31:37-44.  https://doi.org/10.1016/j.ijoa.2017.04.008
  32. de Bernardis RCG, Siaulys MM, Vieira JE, Mathias LAST. Perioperative warming with a thermal gown prevents maternal temperature loss during elective cesarean section. A randomized clinical trial. Brazilian Journal of Anesthesiology. 2016;66:451-455.  https://doi.org/10.1016/j.bjane.2014.12.007
  33. Oshvandi K, Shiri FH, Fazel MR, Safari M, Ravari A. The effect of pre-warmed intravenous fluids on prevention of intraoperative hypothermia in cesarean section. Iranian Journal of Nursing and Midwifery Research. 2014; 19:64-69. 
  34. Brodshaug I, Reine E, Raeder J. Maternal hypothermia during elective caesarean delivery: A prospective observational study. Acta Anaesthesiologica Scandinavica. 2024;68:247-253.  https://doi.org/10.1111/aas.14340
  35. Masuku NJ, du Toit L, King C, Dyer RA, Vawda DO, Bishop DG. Modelling the incidence and severity of hypothermia during spinal anaesthesia for caesarean delivery: a prospective observational study in a resource-limited setting. Southern African Journal of Anaesthesia and Analgesia. 2024;30:6-12.  https://doi.org/10.36303/SAJAA.3045
  36. Meghana VS, Vasudevarao SB, Kamath SS. The effect of combination of warm intravenous fluid infusion and forced air warming versus forced air warming alone on maternal temperature and shivering during cesarian delivery under spinal anesthesia. Annals of African Medicine. 2020;19:137-143.  https://doi.org/10.4103/aam.aam_58_19
  37. du Toit L, van Dyk D, Hofmeyr R, Lombard CJ, Dyer RA. Core Temperature Monitoring in Obstetric Spinal Anesthesia Using an Ingestible Telemetric Sensor. Anesthesia and Analgesia. 2018;126:190-195.  https://doi.org/10.1213/ANE.0000000000002326
  38. Panzer O, Ghazanfari N, Sessler DI, Yücel Y, Greher M, Akça O, et al. Shivering and shivering-like tremor during labor with and without epidural analgesia. Anesthesiology. 1999;90:1609-1616. https://doi.org/10.1097/00000542-199906000-00017
  39. Zhang R, Zhou Q, Guan H. Intraoperative temperature management during emergency cesarean section: a retrospective observational study. BMC Anesthesioloogy. 2024;24:349.  https://doi.org/10.1186/s12871-024-02730-3
  40. Marin L, Höcker J, Esser A, Terhorst R, Sauerwald A, Schröder S. Forced-air warming and continuous core temperature monitoring with zero-heat-flux thermometry during cesarean section: a retrospective observational cohort study. Brazilian Journal of Anesthesiology (English Ediiition). 2022;72:484-492.  https://doi.org/10.1016/j.bjane.2021.10.007
  41. Thorburn PT, Monteiro R, Chakladar A, Cochrane A, Roberts J, South East Anaesthetic Research Chain (SEARCH), Harper CM. Maternal temperature in emergency caesarean section (MATES): an observational multicentre study. International Journal of Obstetric Anesthesia. 2021;46:102963. https://doi.org/10.1016/j.ijoa.2021.102963
  42. Hoefnagel AL, Vanderhoef KL, Anjum A, Damalanka V, Shah SJ, Diachun CA, Mongan PD. Improving intraoperative temperature management in elective repeat cesarean deliveries: a retrospective observational cohort study. Patient Safety in Surgery. 2020;14:14.  https://doi.org/10.1186/s13037-020-00241-x
  43. Sud S, Dwivedi D, Sawhney S, Bhatia J, Davis J, Dudeja P. Comparison of three different fluid warming techniques used to maintain euthermia in patients who underwent cesarean section — A retrospective audit. Journal of Obstetric Anesthesia and Critical Care. 2019;9:35.  https://doi.org/10.4103/joacc.JOACC_52_18
  44. Allen TK, Habib AS. Inadvertent Perioperative Hypothermia Induced by Spinal Anesthesia for Cesarean Delivery Might Be More Significant Than We Think: Are We Doing Enough to Warm Our Parturients? Anesthesia and Analgesia. 2018;126:7-9.  https://doi.org/10.1213/ANE.0000000000002604
  45. Cohen WR. Obstetric Hemorrhage and Hypothermia: Chilling Facts. Open Journal of Obstetrics and Gynecology. 2018;08:1260-1270. https://doi.org/10.4236/ojog.2018.813128
  46. Carpenter L, Baysinger CL. Maintaining perioperative normothermia in the patient undergoing cesarean delivery. Obstetrical and Gynecological Survey. 2012; 67:436-446.  https://doi.org/10.1097/OGX.0b013e3182605ccd
  47. Weishaar K, Bailey E, El Ado Mikdachi H, Murphy JE. Postpartum Maternal Hypothermia in an Adolescent Patient Following Spontaneous Vaginal Delivery. Cureus. 2022 2022;14(8):e28142. https://doi.org/10.7759/cureus.28142
  48. National Institute for Health and Care Excellence. Hypothermia: prevention and management in adults having surgery (Clinical guideline CG65). NICE Clinical Guideline. 2016. Accessed August 12, 2025. https://www.nice.org.uk/guidance/cg65/resources/hypothermia-prevention-and-management-in-adults-having-surgery-pdf-975569636293
  49. Di Marco P, Canneti A. Normotermia Perioperatoria. Buone Pratiche Cliniche SIAART. 2017. Accessed August 12, 2025. https://www.siaarti.it/news/371375
  50. Torossian A, Bräuer A, Höcker J, Bein B, Wulf H, Horn E-P. Preventing inadvertent perioperative hypothermia. Deutsches Arzteblatt International. 2015;112:166-172.  https://doi.org/10.3238/arztebl.2015.0166
  51. Suharwardy S, Carvalho B. Enhanced recovery after surgery for cesarean delivery. Current Opinion in Obstetrics and Gynecology. 2020;32:113-120.  https://doi.org/10.1097/GCO.0000000000000616
  52. Medzhidova DR, Shifman EM, Kulikov A V, Nurmagomedova MN. Traditional fasting cesarean section: what is good and what is bad? Arkhiv akusherstva i ginekologii im. V.F. Snegireva. 2018;5:208-212. (In Russ.). https://doi.org/10.18821/2313-8726-2018-5-4-208-212
  53. Schmied H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet. 1996;347:289-292.  https://doi.org/10.1016/S0140-6736(96)90466-3
  54. Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;108:71-77.  https://doi.org/10.1097/01.anes.0000296719.73450.52
  55. Hui C-K, Huang C-H, Lin C-J, Lau H-P, Chan W-H, Yeh H-M. A randomised double-blind controlled study evaluating the hypothermic effect of 150 microg morphine during spinal anaesthesia for Caesarean section. Anaesthesia. 2006;61:29-31.  https://doi.org/10.1111/j.1365-2044.2005.04466.x
  56. Munday J, Osborne S, Yates P. Intrathecal Morphine-Related Perioperative Hypothermia in Women Undergoing Cesarean Delivery: A Retrospective Case-Control Study. Journal of PeriAnesthesia Nursing. 2018;33:3-12.  https://doi.org/10.1016/j.jopan.2016.04.142

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.