Effect of a Warming Mattress on Perioperative Hypothermia Following Cesarean Delivery

Not Applicable

Terminated

Brief Summary: The primary aim of the current study will be to determine if the use of an underbody heating mattress during cesarean sections will decrease the incidence of postoperative hypothermia, defined as core temperature less than 36C, and if hypothermia occurs, time to normothermia. As part of the primary outcome the difference in the incidence of shivering, its severity, and need for treatment will be investigated. As a secondary goal other maternal perioperative outcomes will be studied i.e. estimated blood loss, change in hemoglobin level on the morning after surgery ie postop day 1, need for blood transfusion, rate of wound infections, length of hospital stay, maternal satisfaction, time to first breastfeeding, time to first 'skin to skin' contact. The relationship between maternal hypothermia and newborn outcomes of temperature and APGAR scores will also be evaluated.

Active preoperative and intraoperative warming may prevents inadvertent perioperative hypothermia and may be beneficial for pregnant patients undergoing cesarean delivery. The underbody warming mattress may be a step towards finding a suitable form of warming that is comfortable for awake patients, does not interfere with skin to skin contact and maternal-fetal bonding.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

• will be age >18 years,
- singleton pregnancy >37 weeks,
- neuraxial anesthesia,
- healthy afebrile patients.

Arm && Interventions

Group	Intervention	Description
Underbody warmer on	VitaHeat underbody heating mattress	Underbody warmer will be underneath the patient and turned on.
Underbody warmer off	VitaHeat underbody heating mattress	Underbody warmer will be underneath the patient but not turned on.

Primary Outcome Measures

Name	Time	Method
Temperature	15 minute intervals until normothermic, up to 45 minutes after admission Post Anesthesia Care Unit	Temperature at time of post anesthesia care unit admission

Secondary Outcome Measures

Name	Time	Method
Number of Participants With Shivering	15 minute intervals until no shivering, up to 45 minutes after admission Post Anesthesia Care Unit	Shivering at time of post anesthesia care unit admission
Vitals: Heart Rate	Preop up to 45 minutes after admission Post Anesthesia Care Unit, 15 min intervals	Vitals: Heart Rate from preoperative through end of post anesthesia recovery unit
Blood Loss	Documented at the end of 2 hour surgical procedure	Estimated blood loss with and without warming
Time to Neonatal Bonding	time from delivery to first maternal contact during the 2 hour surgical procedure	time to neonatal bonding as skin to skin
Thermal Comfort Visual Analog Scale	Preop up to 45 minutes after admission Post Anesthesia Care Unit, 15 min intervals	Thermal comfort visual analog scale with scores 0-100 with 50 being temperature comfort/neutral, 100 being hottest, 0 being cold
Vitals: Oxygen Saturation	Preop up to 45 minutes after admission Post Anesthesia Care Unit, 15 min intervals	Vitals: Oxygen Saturation from preoperative through end post anesthesia recovery unit
Vitals: Blood Pressure	Preop up to 45 minutes after admission Post Anesthesia Care Unit, 15 min intervals	Vitals: blood pressure as mean arterial pressure