Effect of lower leg compression during cesarean section on post-spinal hypotension and neonatal hemodynamic parameters: nonrandomized controlled clinical trial.

Assignment was nonrandomized and used a convenience sample, so baseline differences or staff choices could explain the results. Only the pediatrician and laboratory staff were blind; mothers, anesthetic and operating room staff, and the team measuring blood pressure were not blinded. The stocking group also received lactated Ringer preload, spinal anesthesia, intravenous and indwelling catheter care, and monitoring, so the effect of the stocking alone cannot be separated from those concurrent treatments. The benefit was not consistent across all outcomes: blood pressure differences disappeared at several time points, 5-minute Apgar was not different, and ICU admission was not significantly different. The study was done in a single operating room in Egypt in healthy term elective cesarean patients, so it may not apply to emergency cesarean sections, higher-risk pregnancies, or different settings. The paper did not name one primary outcome; it reports many maternal and neonatal outcomes. The paper gives two hypotension thresholds, 20% in the introduction and 15%-20% in the methods.

The authors declare no conflict of interest.

Do not conclude that lower leg compression alone prevents post-spinal hypotension or improves neonatal outcomes. The trial was nonrandomized, and all parturients also received lactated Ringer preload, spinal anesthesia, intravenous and indwelling catheter care, and monitoring; the contribution of the stocking cannot be separated from those concurrent treatments. The 1-minute Apgar difference was not seen at 5 minutes, and ICU admission was not significantly different.