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Cesarean Section ComplicationsNCT04667000

The Effect of Forced Air Warming During Caseraen Section on Maternal Hypothermia: Randomized Controlled Trial

A study testing Forced Air Warming in people with Cesarean Section Complications and Hypothermia, run by Hacettepe University at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

During the cesarean section; Hypothermia can be seen due to reasons such as anesthesia, premedication drugs, cold operating room environment, exposure of tissues and organs, and use of cold intravenous fluids. Hypothermia associated with cesarean may affect maternal and fetal health negatively. Read more about this study

Who is it for?
Ages 18 to 35 years, women onlyHealthy volunteers can take part
Conditions the study is for
Cesarean Section Complications, Hypothermia
What is being tested?
Forced Air Warming
Could I receive a placebo?
No, everyone receives an active treatment
How many people
35 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 May 2021to 1 Nov 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 35 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • - between the ages of 18-35
  • Speak, understand and write Turkish
  • 37 weeks and more pregnant
  • ASA I (Normal, a disease other than surgical pathology that does not cause a systemic disorder or a healthy person without a systemic problem)
  • Spinal anesthesia is planned
  • No high-risk pregnancy diagnosis (Oligodydroamniosis, early membrane rupture, gestational diabetes mellitus, preeclampsia, fetal tachycardia, nonreactive NST, intrauterine growth retardation)
Show all 9Show fewer
  • Body mass index> 19 kg / m2 and <40 kg / m2,
  • Having a single pregnancy and
  • Pregnant women who agreed to participate in the study will be included in the sample.

Who cannot join

  • - Emergency cesarean section
  • Individuals with Forced Air Warming contraindications (Acute infection, Maternal fever before operation, etc.)
  • In case of any complication that may develop in the mother or newborn at any stage of the research
  • Pregnant women who want to leave the research at any stage of the research will be excluded from the sample.

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Hacettepe University

    Ankara, Ankara, 06100

Other trials in Turkey (Türkiye)

About this study

Official title: The Effect Of Forced Air Warming Used For Different Body Parts During Caseraen Section On Maternal Hypothermia, Shivering, Thermal Comfort, Apgar Score And Breastfeeding: Randomized Controlled Trial

During the cesarean section; Hypothermia can be seen due to reasons such as anesthesia, premedication drugs, cold operating room environment, exposure of tissues and organs, and use of cold intravenous fluids. Hypothermia associated with cesarean may affect maternal and fetal health negatively. As a result of hypothermia, coagulopathy, infection, undesirable cardiac events that cause an increase in oxygen consumption, delay in postoperative recovery and wound healing, postoperative nausea and vomiting, chills and relief may be observed in the mother. Newborns born from hypothermic mothers have lower body temperature, pH and Apgar scores. It is important to evaluate all women in terms of risk factors in the preoperative period in the prevention of hypothermia and complications related to hypothermia. Prevention of hypothermia, which has negative effects on maternal and newborn health, is one of the risks that the nurse can address independently. Therefore, this research; In order to determine the effect of heating different body areas using compressed air heating technique during cesarean section on hypothermia, tremor, thermal comfort, postpartum comfort and maternal satisfaction, a parallel group was planned as a randomized controlled trial. The study is planned to be conducted in Hacettepe University Adult Hospital Gynecology and Obstetrics Department delivery room and obstetrics service. Research data, Introductory Information Form (Appendix 1), Obstetric and Postpartum Features Form (Appendix 2), Patient Monitoring Form (Appendix 3), Termal Comfort Perception Scale (Appendix 4), Shivering Level Diagnostic Form (Appendix 5), LATCH Breastfeeding The Diagnostic and Measurement Tool (Appendix 6) will be collected using the Visual Analogue Scale (Appendix 7) and the Thermal Comfort Scale that will be developed by the researchers. Pregnant women who meet the inclusion criteria will be included in the research. Women will be divided into 4 groups as the lower extremities are heated, the upper extremities are heated, the whole body is heated, and the control group. According to the group of women; It will be heated 30 minutes before surgery and 30 minutes after surgery with lower limb, upper limb or whole body. Women in the control group will not be heated.

Read the detailed description

This study was planned as a parallel group randomized controlled study in order to determine the effect of heating different body parts using forced air warming technique during cesarean section on maternal hypothermia, shivering, thermal comfort, the Apgar score of the newborn and breastfeeding.

In the preparation phase of the research; Determining the rate of hypothermia in women applying to the delivery room of Hacettepe University Adult Hospital for planned cesarean section, determining and procuring the devices to be used in the study, and establishing experimental and control groups will be realized.

Body temperatures of women will be measured for 2 weeks in order to determine the rate of hypothermia in women who have had cesarean section in the institution where the study will be conducted. Body temperature of women will be started 30 minutes before the cesarean section and will be measured every 15 minutes until 30 minutes after the operation. By determining the prevalence of hypothermia after cesarean section in women; It is aimed to reveal the necessity of heating with compressed air heating technique.

  • Women are admitted to the delivery room 60-90 minutes before the cesarean operation. The Introductory Information Form will be applied by the researcher using face-to-face interview before the women are admitted to the operating room.
  • 30 minutes before the operation, women's body temperature, shivering, blood pressure, pulse and respiratory values will be evaluated every 15 minutes and recorded on the Patient Monitoring Form. In addition, the Temperature Comfort Scale, which will be developed by the researchers, will be applied by face to face interview method.

Applications During Cesarean Surgery

  • During the operation, women's body temperature, temperature comfort score, shivering, blood pressure, pulse, respiration and SpO2 values will be evaluated every 15 minutes and recorded on the Patient Monitoring Form.
  • With the birth of the baby; The newborn's body temperature, 1st and 5th minute Apgar score will be evaluated and recorded on the Obstetric and Postpartum Characteristics Form.

Applications to be Made Within 30 Minutes After Cesarean Surgery

  • After the cesarean operation, women will be monitored in the recovery unit for 30 minutes. Body temperature, temperature comfort score, shivering, blood pressure, pulse, respiration and SpO2 values will be evaluated every 15 minutes after the women are admitted to the recovery unit and recorded on the Patient Monitoring Form. In addition, the Temperature Comfort Scale, which will be developed by the researchers, will be applied to women 30 minutes after the operation for the second time.
  • The pain level of women will be evaluated with the Visual Pain Scale 30 minutes after surgery.
  • In the institution where the research will be conducted, all women are given a heated blanket at 70 0C when they feel cold and shiver after cesarean section. The number of covers used varies depending on the demand of the woman. Researcher women will not interrupt this routine care they receive. The number of heated covers used by women will be recorded on the Obstetric and Postpartum Characteristics Form.

Applications to be Performed in Obstetrics and Gynecology Service after Cesarean Operation

  • Information such as the need for analgesia, time to start breastfeeding, first mobilization time, gas, stool and urine output will be obtained from the patient file and recorded in the Obstetric and Postpartum Characteristics Form.
  • The pain level of women will be evaluated repeatedly with the Visual Pain Scale (VAS) at the 24th hour after surgery. Due to the effect of anesthesia and the administration of analgesics upon the request of the doctor within the first day after cesarean operation, the VAS score after 24 hours will be evaluated.
  • Before discharge, the development of postpartum complications in a woman will be evaluated and recorded on the Obstetric and Postpartum Features Form.
  • At Hacettepe University Adult Hospital Gynecology Service, the breastfeeding status of mothers of newborns is evaluated using the LATCH Breastfeeding Diagnostic and Measurement Tool. Effective breastfeeding score assessed by the nurses: LACTH score will be evaluated and recorded on the Obstetric and Postpartum Characteristics Form.
Being tested
Forced Air Warming
Keywords
hypothermia, nursing care, cesarean section
Medical subject headings
Hypothermia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Forced Air WarmingOther

    We will use Forced Air Warming for cesarean patient

Study groups in NCT04667000
Study groupRoleWhat they receive
lower extremitiesExperimentalthe women's lower extremities will be heated with Forced Air Warming
Receives: Other: Forced Air Warming
upper extremitiesExperimentalthe women's upper extremities will be heated with Forced Air Warming
Receives: Other: Forced Air Warming
whole bodyExperimentalthe women's whole body will be heated with Forced Air Warming
Receives: Other: Forced Air Warming
control groupNo interventionthere is no intervention for this group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maternal Hypothermia

    Maternal hypothermia is defined as body temperature falling below 36 ° C.

    Measured: 30 minutes before the intervention to 30 minutes after the intervention.

Secondary outcomes (4)
  1. Shivering

    Shivering is a bodily function in response to cold in humans

    Measured: 30 minutes before the intervention to 30 minutes after the intervention.

  2. Thermal Comfort

    Thermal comfort is defined as the condition of mind that expresses satisfaction with the thermal environment.

    Measured: 30 minutes before the intervention to 30 minutes after the intervention.

  3. Apgar Score

    An objective score of the condition of a baby after birth. This score is determined by scoring the heart rate, respiratory effort, muscle tone, skin color, and response to a catheter in the nostril.

    Measured: 30 minutes before the intervention to 30 minutes after the intervention.

  4. Breastfeeding Timing

    The time between the start of breastfeeding of the newborn after birth

    Measured: 30 minutes before the intervention to 30 minutes after the intervention.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Dec 2020
  2. Study start1 May 2021
  3. Primary completion30 Sep 2022
  4. Study completion1 Nov 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
parallel group randomized controlled study
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
35 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04667000
Sponsor's protocol ID
KA-180051
Status last verified
Dec 2021
First submitted
12 Mar 2020
Last updated
22 Sep 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Akhtar Z, Hesler BD, Fiffick AN, Mascha EJ, Sessler DI, Kurz A, Ayad S, Saager L. A randomized trial of prewarming on patient satisfaction and thermal comfort in outpatient surgery. J Clin Anesth. 2016 Sep;33:376-85. doi: 10.1016/j.jclinane.2016.04.041. Epub 2016 Jun 3.

    PubMed 27555196
  • Apfelbaum JL, Silverstein JH, Chung FF, Connis RT, Fillmore RB, Hunt SE, Nickinovich DG, Schreiner MS, Silverstein JH, Apfelbaum JL, Barlow JC, Chung FF, Connis RT, Fillmore RB, Hunt SE, Joas TA, Nickinovich DG, Schreiner MS; American Society of Anesthesiologists Task Force on Postanesthetic Care. Practice guidelines for postanesthetic care: an updated report by the American Society of Anesthesiologists Task Force on Postanesthetic Care. Anesthesiology. 2013 Feb;118(2):291-307. doi: 10.1097/ALN.0b013e31827773e9. No abstract available.

    PubMed 23364567
  • Arkilic CF, Akca O, Taguchi A, Sessler DI, Kurz A. Temperature monitoring and management during neuraxial anesthesia: an observational study. Anesth Analg. 2000 Sep;91(3):662-6. doi: 10.1097/00000539-200009000-00031.

    PubMed 10960396
  • Badjatia N, Strongilis E, Gordon E, Prescutti M, Fernandez L, Fernandez A, Buitrago M, Schmidt JM, Ostapkovich ND, Mayer SA. Metabolic impact of shivering during therapeutic temperature modulation: the Bedside Shivering Assessment Scale. Stroke. 2008 Dec;39(12):3242-7. doi: 10.1161/STROKEAHA.108.523654. Epub 2008 Oct 16.

    PubMed 18927450
  • Bender M, Self B, Schroeder E, Giap B. Comparing new-technology passive warming versus traditional passive warming methods for optimizing perioperative body core temperature. AORN J. 2015 Aug;102(2):183.e1-8. doi: 10.1016/j.aorn.2015.06.005.

    PubMed 26227528
  • Betran AP, Ye J, Moller AB, Zhang J, Gulmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS One. 2016 Feb 5;11(2):e0148343. doi: 10.1371/journal.pone.0148343. eCollection 2016.

    PubMed 26849801
  • Carpenter L, Baysinger CL. Maintaining perioperative normothermia in the patient undergoing cesarean delivery. Obstet Gynecol Surv. 2012 Jul;67(7):436-46. doi: 10.1097/OGX.0b013e3182605ccd.

    PubMed 22926250
  • Chakladar A, Dixon MJ, Crook D, Harper CM. The effects of a resistive warming mattress during caesarean section: a randomised, controlled trial. Int J Obstet Anesth. 2014 Nov;23(4):309-16. doi: 10.1016/j.ijoa.2014.06.003. Epub 2014 Jun 13.

    PubMed 25266313
  • 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. Int J Obstet Anesth. 2017 May;31:37-44. doi: 10.1016/j.ijoa.2017.04.008. Epub 2017 Apr 27.

    PubMed 28576354
  • 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 J Anesthesiol. 2012 May;62(5):454-60. doi: 10.4097/kjae.2012.62.5.454. Epub 2012 May 24.

    PubMed 22679543
  • 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. Anesth Analg. 2016 May;122(5):1490-7. doi: 10.1213/ANE.0000000000001181.

    PubMed 26895002
  • Duff J, Di Staso R, Cobbe KA, Draper N, Tan S, Halliday E, Middleton S, Lam L, Walker K. Preventing hypothermia in elective arthroscopic shoulder surgery patients: a protocol for a randomised controlled trial. BMC Surg. 2012 Jul 20;12:14. doi: 10.1186/1471-2482-12-14.

    PubMed 22817672
  • Fallis WM, Hamelin K, Symonds J, Wang X. Maternal and newborn outcomes related to maternal warming during cesarean delivery. J Obstet Gynecol Neonatal Nurs. 2006 May-Jun;35(3):324-31. doi: 10.1111/j.1552-6909.2006.00052.x.

    PubMed 16700681
  • Geller EJ, Wu JM, Jannelli ML, Nguyen TV, Visco AG. Maternal outcomes associated with planned vaginal versus planned primary cesarean delivery. Am J Perinatol. 2010 Oct;27(9):675-83. doi: 10.1055/s-0030-1249765. Epub 2010 Mar 16.

    PubMed 20235001
  • Haas DM, Morgan S, Contreras K, Enders S. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database Syst Rev. 2018 Jul 17;7(7):CD007892. doi: 10.1002/14651858.CD007892.pub6.

    PubMed 30016540

Questions about this trial

What is this clinical trial studying?

A study testing Forced Air Warming in people with Cesarean Section Complications and Hypothermia, run by Hacettepe University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maternal Hypothermia (time frame: 30 minutes before the intervention to 30 minutes after the intervention.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04667000, which also lists 46 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Sep 2025; AzTrials last refreshed its copy on 6 Nov 2026.

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