Abstract
(BJOG. 2017;124:678–685) Oxygen is routinely used in the United States for intrauterine resuscitation when fetal heart rate (FHR) abnormalities are present. In fact, an American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin recommended its use as a component of intrauterine resuscitation. It is also commonly used by obstetricians prophylactically during the second stage of labor. However, its efficacy has been debated. Some studies have shown increased maternal oxygen levels with no increase in fetal levels while other studies did report an increase in fetal oxygen saturation when maternal oxygen supplementation was administered. No randomized controlled trials have looked at the effects of supplemental maternal oxygen on nonreassuring FHR and just 2 small trials investigated the effect of prophylactic oxygen administration during the second stage of labor. Finally, hyperoxia has been shown to cause vasoconstriction, including vessels of the placenta and umbilical cord, which could lead to the conclusion that oxygen administration during intrauterine resuscitation may be harmful. This randomized, controlled study evaluated the effects on umbilical artery pH of low flow maternal oxygen administration during the second stage of labor.
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