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Background  Despite the widespread use of oxygen (O 2 ) in intrauterine resuscitation, the obstetric scientists’ understanding of O 2  therapy is full of contradictions. We tested the hypothesis that higher maternal arterial partial pressure of oxygen (PO 2 ) is associated with higher umbilical cord venous PO 2  (UvPO 2 ).    Methods  This is a planned secondary analysis of a randomised controlled trial (RCT), 443 normal women were 1:1 randomly allocated to receive 2 L/min O 2  or room air from the onset of second stage to delivery. We reported that maternal 2 L/min O 2  exposure cannot affect the umbilical cord arterial pH or the fetal heart rate (FHR) pattern. In 217 non-random samples, we found 2 L/min O 2  exposure increased the maternal arterial PO 2  to the median 150 mmHg (hemoglobin would be saturated). The primary outcome for this analysis was UvPO 2  in these non-random samples.    Results  There were no significant differences between the O 2  group ( N  = 107) and the control group ( N  = 110) in the UvPO 2  (median 30.2, interquartile 25.4–35.2 versus median 28.3, interquartile 23.4–35.3, mmHg,  P  = 0.379). There were also no significant differences between room air and different percentiles of O 2  exposure duration (< 25th, ≧ 25th < 50th, ≧ 50th < 75th, ≧ 75th percentile) in the UvPO 2 .    Conclusions  Maternal O 2  exposure at super-physiological levels (median arterial blood PO 2  150 mmHg) in normal labor may not change the UvPO 2 .    Clinical trial registration   ClinicalTrials.gov  NCT02221440 , first posted in 20 August 2014.

bmc pregnancy and childbirth

Maternal oxygen exposure may not change umbilical cord venous partial pressure of oxygen: non-random, paired venous and arterial samples from a randomised controlled trial