Is it a safe practice to administer oxygen during uncomplicated delivery: A randomized controlled trial?

Nesterenko, Tetyana H.; Acun, Ceyda; Mohamed, Mohamed A.; Mohamed, Ahmed; Karcher, Donald S.; Larsen, John W.; Aly, Hany

doi:10.1016/j.earlhumdev.2012.02.007

Cited by 28 publications

(38 citation statements)

References 21 publications

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“…A Cochrane review found no trials addressing the use of oxygen for fetal compromise but the authors identified two trials of prophylactic oxygen in labour which reported a statistically significant increase in the incidence of cord blood acidosis (pH<7.20 or [H + ]>63 nmol/L) in the oxygenation group (relative risk (RR) 3.5, 95% CI 1.34 to 9.19) 357. A small (n=56) randomised trial in Washington, USA reported in 2012 that the delivery room resuscitation rate was 20% for infants of mothers randomised to 2 L of nasal oxygen for at least 30 min before delivery compared with 0% in those receiving air from a nasal cannula (p=0.03) 358. This study reported cord blood acidosis in just one participant in each group.…”

Section: Section 8: Emergency Oxygen Use In Hospital Settingsmentioning

confidence: 99%

BTS guideline for oxygen use in adults in healthcare and emergency settings

O’Driscoll

Howard

Earis

et al. 2017

Thorax

488

376

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Section: Section 8: Emergency Oxygen Use In Hospital Settingsmentioning

confidence: 99%

BTS guideline for oxygen use in adults in healthcare and emergency settings

O’Driscoll

Howard

Earis

et al. 2017

Thorax

488

376

View full text Add to dashboard Cite

“…In a trial of 56 laboring women randomized to oxygen or room air for at least 30 minutes before delivery, Nesterenko et al found that more infants in the oxygen group required delivery room resuscitation. (21)A similar trial by Thorp et al comparing oxygen to room air in the second stage of labor revealed that babies in the oxygen group were four times more likely to have umbilical artery pH values <7.20 and that duration of oxygen exposure had an inverse relationship with cord arterial pH. (22) In a double-blinded trial of room air versus oxygen during elective cesarean delivery, Khaw et al demonstrated that oxygen was associated with increased maternal and umbilical cord levels of malondialdehyde, a marker of free radical activity and oxidative stress.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Hyperoxemia and Risk of Neonatal Morbidity

Raghuraman

Temming

Stout

et al. 2017

Obstetrics &Amp; Gynecology

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Objective To test the hypothesis that intrauterine hyperoxemia is associated with an increased risk of neonatal morbidity. Methods This was a secondary analysis of a prospective study of singleton, non-anomalous deliveries at or beyond 37° weeks at an institution with universal umbilical cord gas policy from 2010 to 2014. The primary outcome was a composite of neonatal morbidity including neonatal death, meconium aspiration syndrome, intubation, mechanical ventilation, hypoxic-ischemic encephalopathy, and hypothermic therapy. Intrauterine hyperoxemia was defined as cord venous PO2 ≥ 90th percentile of the cohort. Adjusted relative risks (aRR) were estimated for neonatal morbidity controlling for confounders. Analysis was performed for the entire cohort and stratified by the presence of acidemia defined as umbilical artery pH<7.1. Results Of 7,789 patients with validated paired cord gases, 106 (1.4%) had the composite neonatal morbidity. There was no difference in composite neonatal morbidity in patients with and without intrauterine hyperoxemia in the entire cohort (1.5% vs 1.3%, aRR 1.5, 95% CI 0.9–2.7). The rate of acidemia was not significantly different in the two groups (1.9% vs 1.8%, aRR 1.5, 95% CI 0.9–2.5). In stratified analysis, there was evidence of effect modification (p for interaction <0.001), with a significant association between intrauterine hyperoxemia and neonatal morbidity in the presence of acidemia (41.2% vs 21.4%, aRR 2.3, 95% CI 1.1–3.5), but not in its absence (0.8% vs 1.0%, aRR 1.0, 95% CI 0.5–2.2). Conclusion Intrauterine hyperoxemia, compared with normoxemia, is associated with a small, but significantly increased risk of neonatal morbidity in acidemic neonates.

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“…Maternal oxygen supplementation during elective caesarean section has been shown to increase the requirement for neonatal resuscitation, and neonatal resuscitation with 100% oxygen is no longer recommended 21 22. Primary focus following maternal trauma must be placed upon the optimal management of maternal health.…”

Section: Methodsmentioning

confidence: 99%