Study	Reason for exclusion
Adekanye 2007	Examines effect on combined spinal‐epidural (not spinal anaesthesia alone)
Adigun 2010	Prevention of hypotension was not a study outcome, instead it examined effect of the interventions on restoration of BP. Aim was treatment not prophylaxis
Akhtar 2011	Inadequate information on number of women allocated to each group
Alahuhta 1994	Intervention aimed to treat hypotension not prevent
Amponsah 2011	Investigated prevention of hypotension resulting from combined spinal‐epidural anaesthesia
Aragao 2014	Intervention aimed to treat hypotension not prevent
Arai 2008	Combined spinal‐epidurals performed
Arboleda 2012	Investigated treatment, rather than prevention, of hypotension
Armstrong 2010	Inadequate reporting of study method. It is unclear if patients received spinal versus epidural versus combined spinal‐epidural
Ashpole 2005	Phenylephrine and ephedrine used to maintain systolic arterial pressure (treating hypotension)
Atalay 2010	Anaesthetic regimen differed between groups
Atashkhoyi 2012	Investigated treatment, rather than prevention, of hypotension
Ayorinde 2001	Combined spinal epidural anaesthesia performed
Aziz 2013	Quasi‐randomised study
Bach 2002	Intervention aimed to treat hypotension not prevent
Balcan 2011	Pharmacological treatment of maternal hypotension was studied. Prophylaxis was not studied
Basuni 2016	Comparison of different anaesthetic techniques
Belzarena 2006	Ephedrine or ethylphenylephrine (etilfrine) were used for treating, not preventing, hypotension
Benhamou 1998	Compared different spinal techniques – intervention was adding clonidine or fentanyl to bupivacaine
Bhar 2011	Incidence of hypotension not reported
Bhattarai 2010	Phenylephrine, ephedrine or mephentermine were used for treating, not preventing hypotension
Bjornestad 2009	Participants received epidural, not spinal anaesthesia
Borgia 2002	Participants underwent combined epidural‐spinal anaesthesia
Bouchnak 2006	Compared different spinal anaesthetic techniques – different rates of anaesthetic administration
Bouslama 2012	Dose of the anaesthetic into spinal was not standardised between the study groups (low dose versus high dose). Comparisons between different anaesthetics techniques not included in this review
Bryson 2007	Compared different spinal anaesthetic techniques – different doses of local anaesthetic.
Butwick 2007	Incidence of hypotension not reported
Cai 2016	Combined spinal‐epidurals performed
Campbell 1993	Compared different spinal anaesthetic techniques – intervention compared 2 different needles
Cardoso 2004b	Metaraminol was used to maintain BP
Cardoso 2005	Phenylephrine or metaraminol were used for treating, not preventing, hypotension
Carvalho 2015	Not a prospective randomised controlled trial (control group was retrospectively collected from case notes). Also incidence of hypotension not reported.
Cesur 2008	This study evaluated different anaesthetic techniques – hyperbaric bupivacaine alone versus sequential subarachnoid injection of plain bupivacaine followed by hyperbaric bupivacaine
Chanimov 2006	Investigation of effect of fluid preload on neonatal acid‐base status (not maternal hypotension)
Choi 2005	Comparison of different anaesthetic techniques
Chung 1996	Compared different spinal anaesthetic techniques – intervention was volume of anaesthetic
Clark 1980	Dopamine was used for treating, not preventing, hypotension
Cohen 2002	Investigated prevention of hypotension for combined spinal‐epidural anaesthesia for caesarean section
Cooper 2002	Phenylephrine and ephedrine used to maintain systolic arterial pressure (treating hypotension)
Cooper 2004	Phenylephrine and ephedrine used to maintain systolic arterial pressure (treating hypotension)
Cooper 2007	Intervention aimed to treat hypotension not prevent
Coppejans 2006	Combined spinal‐epidurals performed
Das 2011	Inadequate data. This study investigates both the prevention and management of hypotension using a infusion which is commenced prior to spinal injection and then titrated according to BP using a predetermined algorithm. It is the initial prevention of hypotension (prior to titration of the vasopressor infusion) that this Cochrane review examines, however, this is impossible to examine based on the published data in this paper.
Datta 1982	Not randomised (allocated according to BP levels)
Davemski 2007	Intervention aimed to treat hypotension not prevent
Defossez 2007	Treatment rather than prevention
Desalu 2005	Ephedrine or saline used to maintain systolic arterial pressure (treating hypotension)
Doherty 2011	Investigated treatment, rather than prevention, of hypotension. Also incidence of hypotension was not reported
Dua 2013	Investigated treatment of hypotension, not prevention of hypotension
Dyer 2009	Phenylephrine and ephedrine used to maintain systolic arterial pressure (treating hypotension)
El‐Hakeem 2011	Incidence of hypotension not reported
Evron 2007	Investigated prevention of hypotension following combined spinal‐epidural anaesthesia (not spinal anaesthesia alone)
Fabrizi 1998	Inadequate data on specific numbers for incidence of hypotension in each group
Farber 2015	Techniques to prevent incidence of hypotension following spinal anaesthesia for caesarean section not investigated
Forkner 2012	Combined spinal‐epidural anaesthesia performed
Foss 2014	Incidence of hypotension not reported
Frikha 2008	Inadequate data. The number of participants in each study group was not reported.
Frolich 2001	Study not adequately controlled with respect to fluid administration. Methods to prevent maternal hypotension was not a study outcome
Fuzier 2005	Treatment, not prevention, of hypotension
Gallo 1996	Compared different spinal anaesthetic techniques – 2 doses of bupivacaine
Gambling 2015	Combined spinal‐epidural anaesthesia performed
Garrison 2005	Intervention was early identification of signs of hypotension so that women received prompt treatment
George 2015	Treatment, rather than prevention, of hypotension
Goudie 1988	Participants not randomised ('sequential allocation')
Guasch 2010	Investigated different anaesthetic techniques in prevention of maternal hypotension
Guillon 2010	Incidence of hypotension not reported
Gulec 2012	Investigated different doses of levobupivacaine into a combined spinal‐epidural anaesthetic
Gulhas 2013	Only women who developed hypotension were randomised
Gunda 2010	Ephedrine or phenylephrine were used to treat, not prevent, hypotension
Gupta 2012	Women given combined spinal epidural anaesthesia
Gutsche 1976	No mention of randomisation
Hahn 1998	BP 'maintained', thus not prevention
Hamzei 2015	Different anaesthetic agent doses for spinal anaesthesia were compared
Hanss 2006	Quasi‐randomised trial
Haruta 1987	Investigated treatment of hypotension; no definition of hypotension; no evidence of randomisation
Hennebry 2009	Combined spinal‐epidurals performed
Higgins 2015	Investigated treatment of hypotension, not prevention
Housni 2004	Studied the effect of the rate of injection of bupivacaine on haemodynamic changes in elective caesarean
Husaini 1998	Hypotension treated not prevented ‐ ephedrine manually regulated to keep BP in normal range
Iwama 2002	2 different anaesthetics used ‐ not a randomised trial
Jackson 1995	BP was maintained by ephedrine infusion as well as treated according to rescue criteria for hypotension
Jain 2008	Maintenance, not prevention of hypotension
James 1996	Interventions were differing needle orientations
Javed 2014	Comparison of different anaesthetic techniques
John 2013	Inadequate data – incidence of hypotension following spinal anaesthesia was not reported
Kamrul 2012	Investigated methods of preventing oxytocin induced hypotension by co‐administration of phenylephrine. Preventing of spinal anaesthesia induced hypotension was not investigated.
Kang 1982	BP 'maintained', thus not prevention
Kang 1996	Epidural anaesthesia used
Kangas‐Saarela 1990	Despite adequate definition of hypotension, any fall in BP was treated with ephedrine boluses – not prevention
Kansal 2005	BP 'maintained', thus not prevention
Kaya 2007	Combined spinal epidural anaesthesia performed
Keera 2016	Different anaesthetic techniques compared
Kinsella 2012	Incidence of hypotension not reported
Ko 2007	Combined spinal‐epidurals performed
Kumar 2013	Treatment rather than prevention of spinal hypotension was investigated
Kutlesic 2012	Different anaesthetic techniques investigated
Lal 2015	Intervention aimed to treat hypotension, not prevent
Langesaeter 2008	Combined spinal‐epidurals performed
LaPorta 1995	Comparison of pressors used to treat hypotension, not prevention
Law 2003	Incidence of hypotension not reported
Lee 2005	Intervention aimed to treat hypotension not prevent.
Lee 2008	Investigated prevention of hypotension in combined spinal‐epidural anaesthesia
Lee 2012	Prevention of hypotension was not investigated
Lee 2015	Combined spinal‐epidural anaesthesia performed
Lee 2016	Combined spinal‐epidural anaesthesia performed
Lewis 2004	Ephedrine and/or fluid used to maintain BP
Liu 2010	Epidural anaesthesia used
Luo 2016	Treatment, rather than prevention, of hypotension
Madi‐Jebara 2007	Intervention aimed to treat hypotension not prevent
Mahajan 2009	Study meets criteria for inclusion but unable to interpret data/results presented in paper. Attempted to contact to resolve but no response.
Matorras 1998	Anaesthetist made decision of whether women had general anaesthetic or spinal anaesthesia. Different anaesthetic techniques used therefore excluded
Matsota 2013	Group allocation was not reported. It was not reported to be a "randomised" study
Matsota 2015	Combined spinal‐epidural anaesthesia performed
McDonald 2011	Combined spinal‐epidurals performed
McLeod 2010	Prevention of hypotension following spinal anaesthesia was not investigated.
Mebazaa 2010	This study investigates different spinal anaesthetic doses (i.e. reduction in bupivacaine dose) effect on incidence of hypotension
Mendonca 2003	Combined spinal‐epidurals performed
Mercier 2001	Investigated treatment of hypotension
Miller 2000	Unclear how many women were allocated to each study group
Mitra 2014	This RCT was included in comparison 7 (colloid versus crystalloid) in the Cyna 2017 updated review. However, this study has since been retracted by the Saudi Journal of Anaesthesia and we have now reclassified this study from included to excluded.
Mohta 2008	Dose‐finding comparison between ephedrine and phenylephrine, not a randomised trial
Mohta 2015	Investigated treatment rather than prevention of hypotension
Mohta 2016	Treatment, rather than prevention, of hypotension
Moore 2000	Investigates effect of speed of spinal local anaesthetic injection on incidence of hypotension
Moore 2014	Different anaesthetic agent doses for spinal anaesthesia were compared
Moran 1991	Comparison of pressors used to maintain BP, not used for prevention
Mowbray 2002	Phenylephrine and ephedrine were used for treating, not preventing, hypotension
Narejo 2012	Investigated 2 different types of local anaesthetic used in intrathecal injection and their effects on the incidence of hypotension
Nasir 2005	Comparison of different anaesthetic regimens
Negron 2010	Combined spinal‐epidural anaesthesia performed
Ngan 2016	Treatment, rather than prevention, of hypotension
Ngan Kee 2001a	Metaraminol was used for treating, not preventing, hypotension
Ngan Kee 2001b	Metaraminol was used for treating, not preventing, hypotension
Ngan Kee 2001c	Metaraminol was used for treating, not preventing, hypotension
Ngan Kee 2004b	Thresholds of systolic arterial pressure randomised rather than prophylactic interventions
Ngan Kee 2005	Phenylephrine was used to maintain systolic arterial pressure (treating hypotension)
Ngan Kee 2008a	Treatment, not prevention
Ngan Kee 2008b	Treatment, not prevention
Ngan Kee 2009	Phenylephrine and ephedrine were used to maintain systolic arterial pressure (treating hypotension)
Ngan Kee 2011	Methods to maintain maternal BP was investigated, not methods to prevent hypotension
Ngan Kee 2013b	Methods to maintain maternal BP was investigated, not methods to prevent hypotension
Ngan Kee 2015	Investigated treatment of hypotension
Nishikawa 2004	Results not reported for all women who were randomised (5 emergency caesareans not reported in the groups to which they were randomised)
Norris 1987	Crystalloids used for maintaining BP
Norris 1989	Incidence of hypotension not reported
Nutangi 2013	This study investigates the efficacy of vasopressors in treatment (not prevention) of postspinal hypotension.
Nze 2003	Incidence of hypotension not reported
Ocio 2013	Combined spinal‐epidural anaesthesia performed
Okutan 2006	Incidence of hypotension not reported
Osseyran 2011	Anaesthetic techniques varied among participants: spinal anaesthetic is not controlled and position of patient variable (variable bupivicaine dose according to height of patient, ± fentanyl, positioned in supine or side‐lying for SAB).
Park 1996	Study was uncontrolled with respect to haemodynamics – "...ephedrine and additional fluid were given at the discretion of the anesthesiologist ... to maintain a systolic BP > 100 mmHg or 80% of baseline"
Peng 2013	Combined spinal‐epidural anaesthesia conducted, not spinal anaesthesia alone
Pickford 2000	Despite adequate definition of hypotension, rescue ephedrine was also given for nausea and hypotension was not reported
Prakash 2010	Phenylephrine and ephedrine were used to treat, not prevent, hypotension
Quan 2013	Incidence of hypotension not reported
Quan 2014	Combined spinal epidurals performed
Quan 2015	Different anaesthetic agents for spinal anaesthesia were compared
Quan 2016	Different anaesthetic techniques compared
Quiney 1995	Study not adequately controlled – BP maintained within 20% of preoperative value of baseline by adjusting infusion rate of ephedrine in Hartmann's solution
Rashad 2013	Investigated treatment of hypotension
Reed 2006	Intervention aimed to manage hypotension not prevent
Rehman 2011	This study investigated the efficacy of prophylactic ephedrine given soon after spinal block compared to those women who were given treatment boluses of ephedrine only after they developed hypotension
Rewari 2015	Number of women allocated to each study group not reported
Ronenson 2014	Intervention was using different doses of anaesthetic
Rout 1993b	Quasi‐randomised study
Rout 2000	Unclear definition of hypotension
Rucklidge 2002	Combined spinal‐epidurals performed
Rucklidge 2005	Combined spinal‐epidurals performed
Rumboll 2015	Prevention of oxytocin‐induced hypotension rather than prevention of spinal‐induced hypotension
Russell 2002	Combined spinal‐epidurals performed
Sahin 2015	Number of women allocated to each study group not reported
Sakr 2014	Combined spinal epidurals performed
Sanwal 2008	Investigated effects of intrathecal midazolam in addition to bupivacaine on post‐spinal hypotension
Saravanan 2006	Combined spinal‐epidurals performed
Schofield 2011	Intervention aimed to treat hypotension not prevent
Seltenrich 2001	Comparison of injection rates of spinal anaesthetic
Seyedhejazi 2007	Investigated the effect of different doses of bupivacaine‐fentanyl on postspinal hypotension
Sherif 2013	Investigated treatment not prevention of hypotension in women having spinal anaesthesia for caesarean section
Shifman 2007	Epidurals performed
Siddik‐Sayyid 2013	Not reported as a randomised study
Siddik‐Sayyid 2014	Techniques to treat, rather than prevent, hypotension
Siddiqui 2016	Compared different anaesthetic doses/regimens
Simon 1999	Compared fast and slow injection rates; no mention of randomisation
Sivevski 2006	Investigated effect of plain bupivacaine versus lower dose bupivacaine with fentanyl on the incidence of hypotension
Sng 2013	Investigated treatment, not prevention of hypotension
Sng 2014	Techniques to treat, rather than prevent, hypotension
Sprague 1976	Not randomised – allocation was sequential
Stewart 2010	Combined spinal‐epidurals performed
Stewart 2011	Investigated the effect of differing rates of phenylephrine infusions (used for the treatment of maternal hypotension) on the incidence of maternal reactive hypertension
Stoneham 1999	Compared different spinal anaesthetic techniques – spinal given in different positions
Sumikura 2009	Investigated the effect of preloading with lactated or bicarbonate Ringer's solutions on fetal acid base balance. Maternal BP was not reported
Szmuk 2008	Treatment, not prevention
Tamilselvan 2009	Combined spinal‐epidurals performed
Tanaka 2007	Not a randomised controlled trial
Tanaka 2008	Phenylephrine dose finding study, not randomised trial
Tang 2015	Combined spinal‐epidural performed; compared different anaesthetic techniques
Tekyeh 2013	Different doses of spinal local anaesthetic compared
Teoh 2009	Not prophylaxis – arterial BP was maintained at 90% to 100% of baseline values
Thomas 2001	Thresholds of systolic arterial pressure randomised rather than prophylactic interventions
Thomas 2004	Given as treatment not prophylaxis
Thomas 2006	Treatment given as baby was born
Tolia 2008	Compared different spinal anaesthetic techniques – different doses of anaesthetics
Turker 2011	Incidence of hypotension not reported
Vallejo 2015	Incidence of hypotension not reported
Van Bogaert 1998	The method by which hypotension was treated was not clearly reported, and potentially inconsistent between study participants
Vercauteren 1996	Investigated CSE technique
Vercauteren 2000	Combined spinal‐epidurals performed
Vincent 1998	Study not adequately controlled – BP maintained at 90% – 100% of baseline by adjusting infusions of intervention pressor
Vuffray 2005a	Treatment, rather than prevention, of hypotension
Vuffray 2005b	Treatment, rather than prevention, of hypotension
Wang 2011	Intervention aimed to treat hypotension not prevent
Wang 2015	Combined spinal epidurals performed
Williamson 2009	Comparison of different spinal anaesthetic techniques
Wojciechowski 2008	Incidence of hypotension not reported
Wollman 1968	No mention of randomisation of study participants. 'Control group' included 5 parturients having vaginal birth
Xiao 2015a	Combined spinal epidurals performed
Xiao 2015b	Combined spinal epidurals performed
Xu 2012	Not a randomised trial. This study aimed to determine the median effective volume of crystalloid in preventing hypotension in women undergoing caesarean delivery with spinal anaesthesia.
Xu 2014	Combined spinal‐epidural anaesthesia performed
Yadav 2012	Intervention aimed to treat hypotension not prevent
Yentis 2000	Combined spinal‐epidurals performed
Yokoyama 2004	Variable bupivicaine dosing was used: "The amount of 0.5% bupivacaine hyperbaric solution to be administered was adjusted to aim for a level of anaesthesia of T4, at 2.5ml, with reference to the weight of the patient."
Yoon 2012	Incidence of hypotension not reported
Young 1996	Intervention aimed to treat hypotension not prevent
Yun 1998	Combined spinal‐epidurals performed
Yurtlu 2012	Investigated effect of hyperbaric, isobaric and combinations of bupivacaine for spinal anaesthesia
Zakowski 1992	Comparison of pressors to treat, not prevent, hypotension
Zasa 2015	Only randomised women at high risk of developing hypotension
Zhou 2008	Combined spinal‐epidurals performed

BP: blood pressure; CSE: combined spinal‐epidural; SBP: systolic blood pressure.