Supplemental Oxygen Study: A Randomized Controlled Study on the Effect of Maternal Oxygen Supplementation during Planned Cesarean Delivery on Umbilical Cord Gases

Valeria B. Simon; Alex Fong; Michael P. Nageotte

doi:10.1055/s-0037-1606184

American Journal of Perinatology, Table of Contents

Am J Perinatol 2018; 35(01): 084-089
DOI: 10.1055/s-0037-1606184

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Supplemental Oxygen Study: A Randomized Controlled Study on the Effect of Maternal Oxygen Supplementation during Planned Cesarean Delivery on Umbilical Cord Gases

Valeria B. Simon

¹Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California

,

Alex Fong

²Department of Obstetrics and Gynecology, Miller Children's and Women's Hospital/Long Beach Memorial Medical Center, Long Beach, California

,

Michael P. Nageotte

²Department of Obstetrics and Gynecology, Miller Children's and Women's Hospital/Long Beach Memorial Medical Center, Long Beach, California

› Author Affiliations

Abstract

Objective The aim was to determine the fetal umbilical blood gas effects of supplemental maternal oxygenation compared with room air (RA) during term planned cesarean delivery.

Methods This is a prospective randomized controlled study of singleton planned cesarean deliveries randomized to receive supplemental oxygen (O₂) at 10 L per minute (L/min) via facemask or RA. Umbilical cord gases were collected. The primary outcome was umbilical arterial pH level. Secondary outcomes included umbilical cord values and maternal and neonatal outcomes. Data were expressed as median ± interquartile range (IQR).

Results Seventy subjects in total were enrolled, with 65 subjects available for analysis. The median umbilical arterial pO₂ was significantly increased in the supplemental O₂ group (18 [13.5–20.5] mm Hg) versus RA group (16 [12–18] mm Hg), p = 0.04). The median umbilical venous pO₂ was significantly increased in the supplemental O₂ group (32 [26.5–36.0] mm Hg) versus RA group (28.5 [22–34.3] mm Hg), p = 0.04). There were no significant differences with other umbilical blood gas values and composite maternal or neonatal complications.

Conclusion Subjects with term singleton gestations receiving O₂ at 10 L/min during cesarean delivery compared with RA demonstrated no significant change in umbilical cord pH values. There was a significant increase in umbilical cord arterial and venous O₂ levels in those receiving O₂.

Keywords

cesarean delivery - supplemental O₂ - umbilical arterial pH - umbilical cord gases

Full Text

References

References
1 American College of Obstetricians and Gynecologists. Practice bulletin no. 116: management of intrapartum fetal heart rate tracings. Obstet Gynecol 2010; 116: 1232-1240
2 Clark SL, Nageotte MP, Garite TJ. , et al. Intrapartum management of category II fetal heart rate tracings: towards standardization of care. Am J Obstet Gynecol 2013; 209 (02) 89-97
3 Haydon ML, Gorenberg DM, Nageotte MP. , et al. The effect of maternal oxygen administration on fetal pulse oximetry during labor in fetuses with nonreassuring fetal heart rate patterns. Am J Obstet Gynecol 2006; 195 (03) 735-738
4 Thorp JA, Trobough T, Evans R, Hedrick J, Yeast JD. The effect of maternal oxygen administration during the second stage of labor on umbilical cord blood gas values: a randomized controlled prospective trial. Am J Obstet Gynecol 1995; 172 (2 Pt 1): 465-474
5 Sirimai K, Atisook R, Boriboonhirunsam D. The correlation of intrapartum maternal oxygen administration and umbilical cord blood gas values. Acta Obstet Gynecol Scand Suppl 1997; 76: 90
6 Chatmongkolchart S, Prathep S. Supplemental oxygen for caesarean section during regional anaesthesia. Cochrane Database Syst Rev 2016; 3: CD006161
7 Khaw KS, Wang CC, Ngan Kee WD, Pang CP, Rogers MS. Effects of high inspired oxygen fraction during elective caesarean section under spinal anaesthesia on maternal and fetal oxygenation and lipid peroxidation. Br J Anaesth 2002; 88 (01) 18-23
8 Northway WJr, Rosan RC, Porter DY. Pulmonary disease following respiratory therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med 1967; 276 (07) 367-368
9 Vento M, Sastre J, Asensi MA, Viña J. Room-air resuscitation causes less damage to heart and kidney than 100% oxygen. Am J Respir Crit Care Med 2005; 172 (11) 1393-1398