Effects of maternal supplementary oxygen on the newborn for elective cesarean deliveries under spinal anesthesia

Günaydın, Berrin; Nas, Tuncay; Bırı, Aydan; Koç, Esin; Koc, Ayfer; McCusker, Kevin

doi:10.1007/s00540-011-1123-6

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…Ten trials were performed in patients undergoing scheduled CD with regional anesthesia and 4 trials were performed in women in labor . One trial included both scheduled CD and emergent CD during labor, and another trial only included patients undergoing emergency CD during labor.…”

Section: Resultsmentioning

confidence: 99%

“…Eight trials were considered at low risk for bias . Three studies did not report or lacked valid randomization methods .…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen trials reported results for UA pH—the primary outcome of this review . One of these trials had a cohort of patients randomized at the time of the scheduled CD and another cohort randomized at the time of an emergent CD during labor.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies reported the outcome of UA Pa o 2 . Nine included patients with a scheduled CD, 3 included women who were in labor, and 1 included both scheduled CD and labor groups that were analyzed separately . There was significant heterogeneity among all studies ( I 2 = 90.37%; P < .01).…”

Section: Resultsmentioning

confidence: 99%

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Maternal Oxygen Supplementation Compared With Room Air for Intrauterine Resuscitation

et al. 2021

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IMPORTANCE Supplemental oxygen is commonly administered to pregnant women at the time of delivery to prevent fetal hypoxia and acidemia. There is mixed evidence on the utility of this practice.OBJECTIVE To compare the association of peripartum maternal oxygen administration with room air on umbilical artery (UA) gas measures and neonatal outcomes.DATA SOURCES Ovid MEDLINE, Embase, Scopus, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials were searched from February 18 to April 3, 2020. Search terms included labor or obstetric delivery and oxygen therapy and fetal blood or blood gas or acid-base imbalance.STUDY SELECTION Studies were included if they were randomized clinical trials comparing oxygen with room air at the time of scheduled cesarean delivery or labor in patients with singleton, nonanomalous pregnancies. Studies that did not collect paired umbilical cord gas samples or did not report either UA pH or UA PaO 2 results were excluded.DATA EXTRACTION AND SYNTHESIS Data were extracted by 2 independent reviewers. The analysis was stratified by the presence or absence of labor at the time of randomization. Data were pooled using random-effects models. MAIN OUTCOMES AND MEASURESThe primary outcome for this review was UA pH. Secondary outcomes included UA pH less than 7.2, UA PaO 2 , UA base excess, 1-and 5-minute Apgar scores, and neonatal intensive care unit admission. RESULTSThe meta-analysis included 16 randomized clinical trials (n = 1078 oxygen group and n = 974 room air group). There was significant heterogeneity among the studies (I 2 = 49.88%; P = .03). Overall, oxygen administration was associated with no significant difference in UA pH (weighted mean difference, 0.00; 95% CI, −0.01 to 0.01). Oxygen use was associated with an increase in UA PaO 2 (weighted mean difference, 2.57 mm Hg; 95% CI, 0.80-4.34 mm Hg) but no significant difference in UA base excess, UA pH less than 7.2, Apgar scores, or neonatal intensive care unit admissions. Umbilical artery pH values remained similar between groups after accounting for the risk of bias, type of oxygen delivery device, and fraction of inspired oxygen. After stratifying by the presence or absence of labor, oxygen administration in women undergoing scheduled cesarean delivery was associated with increased UA PaO 2 (weighted mean difference, 2.12 mm Hg; 95% CI, 0.09-4.15 mm Hg) and a reduction in the incidence of UA pH less than 7.2 (relative risk, 0.63; 95% CI, 0.43-0.90), but these changes were not noted among those in labor (PaO 2 : weighted mean difference, 3.60 mm Hg; 95% CI, −0.30 to 7.49 mm Hg; UA pH<7.2: relative risk, 1.34; 95% CI, 0.58-3.11).CONCLUSIONS AND RELEVANCE This systematic review and meta-analysis suggests that studies to date showed no association between maternal oxygen and a clinically relevant improvement in UA pH or other neonatal outcomes.

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Section: Resultsmentioning

confidence: 99%

“…Eight trials were considered at low risk for bias . Three studies did not report or lacked valid randomization methods .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Maternal Oxygen Supplementation Compared With Room Air for Intrauterine Resuscitation

et al. 2021

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“…5,9,10 Cerebral oximetry with near-infrared spectroscopy (NIRS) allows continuous and non-invasive monitoring of rSO 2 , which reflects a balance between cerebral oxygen supply and demand. 11 NIRS quantitates a venous-weighted ratio of oxygenated and deoxygenated hemoglobin in the region of the cerebral cortex underlying the sensors, which are usually placed on the forehead.…”

Section: Discussionmentioning

confidence: 99%

Effects of carbon dioxide insufflation on regional cerebral oxygenation during laparoscopic surgery in children: a prospective study

Tuna

Akkoyun²,

Darçın³

et al. 2016

Brazilian Journal of Anesthesiology (English Edition)

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Supplemental oxygen for caesarean section during regional anaesthesia

Chatmongkolchart

Prathep

2013

Cochrane Database of Systematic Reviews

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Effects of maternal supplementary oxygen on the newborn for elective cesarean deliveries under spinal anesthesia

Abstract: The effect of maternal supplementary oxygen on the newborn has been demonstrated by a cerebral oximeter monitor and supported by umbilical cord blood gas analysis and Apgar scores.

Cited by 10 publications

References 17 publications

Maternal Oxygen Supplementation Compared With Room Air for Intrauterine Resuscitation

Maternal Oxygen Supplementation Compared With Room Air for Intrauterine Resuscitation

Effects of carbon dioxide insufflation on regional cerebral oxygenation during laparoscopic surgery in children: a prospective study

Supplemental oxygen for caesarean section during regional anaesthesia

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