Seven studies (n=292) were included in the review.
The studies were considered to be of a good quality, with all being double-blind. There was no difference between the treatments for the management, prevention and treatment of hypotension (7 trials; RR 1.00, 95% CI: 0.96, 1.06), the treatment of hypotension (4 trials; RR 1.00, 95% CI: 0.95, 1.05), or the risk of hypotension (3 trials; RR 1.09, 95% CI: 0.71, 1.69). There was no difference in the risk of hypertension between the two treatments (3 trials; RR 0.65, 95% CI: 0.08, 5.13).
Patients in the phenylephrine group were more likely to develop bradycardia (3 trials; RR 4.79, 95% CI: 1.47, 15.60).
Women in the phenylephrine group had neonates with higher umbilical arterial pH values (6 trials; WMD 0.03, 95% CI: 0.02, 0.04), but there was no difference between the treatments for incidence of true foetal acidosis (3 trials; RR 0.78, 95% CI: 0.16, 3.92) or Apgar score of more than 7 at one and five minutes (6 trials; RR 0.77, 95% CI: 0.17, 3.51 and RR 1.00, 95% CI: 0.21, 4.83, respectively).