Sezaryen Ameliyatında Farklı Vücut Bölgelerinin Basınçlı Hava Isıtma Tekniği Kullanılarak Isıtılmasının Maternal Hipotermi, Titreme, Termal Rahatlık, Yenidoğan APGAR Skoru ve Emzirmeye Etkisi: Randomize Kontrollü Çalışma

Abstract

This study was carried out as a parallel-group randomized controlled study to determine the effect of warming only the lower extremities, only the upper extremities and the whole body using forced-air warming technique in cesarean section on maternal hypothermia, shivering, thermal comfort, newborn APGAR score, and breastfeeding success. The study sample consisted of 76 pregnant women who applied to the delivery unit of Hacettepe University Adult Hospital between March 3 and April 30, 2021, for a planned cesarean section. The study was carried out with four groups: the whole body warming group (n=19), only the upper extremity warming group (n=19), only the lower extremity warming group (n=19), and the control group (n=19). The women in the intervention group were warmed up 30 minutes before the surgery and continued 30 minutes after the surgery. Their body temperature, level of shivering, and level of thermal comfort were evaluated every 15 minutes. The research data were collected using Introductory Information Form, Obstetrics and Postpartum Characteristics Form, Follow-up Form, Thermal Comfort Scale developed within the scope of the thesis study, Thermal Comfort Perception Scale, Shivering Level Diagnostic Form, LATCH Breastfeeding Assessment Tool, and Visual Analog Scale. At the beginning of the surgery, hypothermia was observed only in control (%26,32) and lower extremity warming (%5,26) groups; hypothermia was observed from the 15th minute of the surgery in the upper extremity warming group (%10,53) and the 60th minute of the surgery in the whole-body warming group (%5,26). After the surgery, shivering was observed in 31.60% of the women in the control group; no shivering was observed in the intervention groups (p=0,001). While there was no difference between the groups in terms of temperature comfort perception scores 30 minutes before the surgery, it was determined that there was a significant difference between the groups in subsequent measurements (p=0.001). However, there was no significant difference between the intervention and control groups in terms of thermal comfort. It was determined that newborn 1st and 5th minute APGAR scores were above 7 points in all groups (p<0.05). It was determined that the LATCH score of the whole body warming group (8) was lower than the scores of the upper extremity warming group (9) and the lower extremity warming group (10) (p=0.009). As a result of the research, nurses should use the forced air warming technique to prevent hypothermia and shivering in women who had a cesarean section.