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Am J Perinatol 2018; 35(11): 1057-1064
DOI: 10.1055/s-0038-1639357
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Liberal versus Indicated Maternal Oxygen Supplementation in Labor: A Before-and-After Trial

Nana-Ama E. Ankumah
1   Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Sean C. Blackwell
1   Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Mesk A. Alrais
1   Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Farah H. Amro
2   Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Rachel L. Wiley
2   Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Patricia Heale
3   Children's Memorial Hermann Hospital, The Women's Center, Labor and Delivery, Houston, Texas
,
Maria Hutchinson
1   Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
,
Baha M. Sibai
1   Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
› Author Affiliations
Funding This study received partial support from Larry C. Gilstrap MD, Center for Perinatal and Women's Health Research.
Further Information

Publication History

21 November 2017

15 February 2018

Publication Date:
26 March 2018 (online)

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Abstract

Background Although supplemental oxygen (SO2) is routinely administered to laboring gravidas, benefits and harms are not well studied.

Objective This article compares strategies of liberal versus indicated SO2 therapy during labor on cesarean delivery (CD) rate and neonatal outcomes.

Study Design A controlled, before-and-after trial of laboring women with term, singleton pregnancies. During an initial 8-week period, maternal SO2 was administered at the discretion of the provider followed by an 8-week period where SO2 was to be given only for protocol indications.

Results Our study included 844 women. There was no difference in number of women receiving SO2 (53% liberal vs. 50% indicated; p = 0.33). For those receiving SO2, there was no difference in SO2 duration (median, 89 minutes [interquartile range, 42–172] vs. 87 minutes [36–152]; p = 0.42). There were no differences in overall CD rate (20% vs. 17%; p = 0.70), CD for nonreassuring fetal status, or use of intrauterine resuscitative measures. There were more 5-minute APGAR < 7 in the indicated group, but no difference in umbilical artery pH < 7.1 or neonatal intensive care unit (NICU) admission.

Conclusion Approximately half of women receive SO2 intrapartum regardless of a strategy of liberal or indicated oxygen use. There were no clinically significant differences in outcomes between strategies.

Keywords

intrauterine resuscitation - labor - maternal oxygen supplementation - oxygen

Note

Registered on ClinicalTrials.gov, NCT 02752490. This article was presented as a poster presentation at the 37th annual meeting of the Society for Maternal-Fetal Medicine, January 23–27, 2017, Las Vegas, Nevada.