Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


School of Nursing




This systematic review compared the efficacy and safety of ephedrine with phenylephrine for the treatment of hypotension during spinal anesthesia for cesarean delivery. Hypotension during cesarean section delivery can have detrimental effects on both the mother and the neonate. Some vasoactive medications such as ephedrine and phenylephrine have been found to be detrimental to the neonate and divert fetal blood flow. After a systematic search of the electronic database PubMed, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart was used to identify appropriate research. Studies were illustrated in a table to identify key variables and were then critically appraised. Outcomes included oxygen supplementation use, ASA classification, IV fluid prehydration, hypotension incidence after spinal anesthesia, spinal solution and technique, umbilical artery pH, Apgar scores, and nausea and vomiting during the case. Findings revealed no difference in the use of oxygen supplementation, ASA classification, IV fluid prehydration, spinal solution or technique on fetal umbilical artery pH. Women given phenylephrine had neonates with higher umbilical artery pH values than those given ephedrine but there was no significant difference between the two vasopressors in the incidence of true fetal acidosis (umbilical artery pH < 7.20 or Apgar