Comparison of Perioperative Temperature Monitoring Sites During Elective Cesarean Deliveries: A Quality Improvement Initiative

TL;DR

This study compares different methods for measuring body temperature during cesarean deliveries to improve patient safety.

Contribution

The study evaluates three temperature monitoring sites during cesarean deliveries under neuraxial anesthesia to determine their reliability.

Findings

Oral temperature showed a moderate correlation with bladder temperature but weak correlation with skin temperature.

Bladder temperature measurements indicated a higher percentage of hypothermia compared to oral and skin measurements.

Skin temperature measurements showed a weak correlation with oral measurements.

Abstract

Background: Impaired thermoregulation secondary to neuraxial anesthesia during cesarean delivery (CD) can contribute to perioperative hypothermia and maternal morbidity. While temperature monitoring during CDs can detect hypothermia, the optimal temperature measurement modality for CDs under neuraxial anesthesia remains unclear. The aim of this quality improvement (QI) initiative was to compare perioperative temperature measurement modalities during CDs.

Methods: Thirty patients undergoing scheduled CDs were selected for this Institutional Review Board (IRB)-exempt QI initiative. Patients received standard neuraxial anesthesia and intraoperative care including active warming. Temperature measurements were taken at three perioperative time points: at skin incision, within 15 minutes after delivery of the infant(s), and at skin closure. Three modalities were used to measure temperature each time: (1) temperature-sensing Foley catheter, (2) oral temperature probe, and (3) skin temperature probe. Temperature modalities were compared using mean differences ± SD, correlation coefficients, and Bland-Altman (BA) plots.

Results: The mean difference between oral vs. skin and oral vs. bladder temperatures was 0.238°C ± 0.380°C and 0.368°C ± 0.361°C, respectively. The overall temperature correlations between oral vs. skin, oral vs. bladder, and skin vs. bladder were 0.225, 0.588, and 0.198, respectively. In the end, the percentage of hypothermic temperatures (below 36°C) by modality were 0% (oral), 10% (skin), and 26.7% (bladder).

Conclusions: The results suggest a weak correlation between oral and skin temperature measurements, and a moderate correlation between oral and bladder temperatures. These findings should be considered when evaluating hypothermia after CD to enhance patient safety and guide improvement efforts.

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