Intrauterine resuscitation during labor: should maternal oxygen administration be a first-line measure?
Intrauterine resuscitation techniques are often used during labor when the fetal heart rate pattern is nonreassuring. These techniques have not been well studied; common practices are based on classic studies many years old. Models of intrauterine resuscitation using one (or more) technique as a first-line intervention and adding others in a specific series or clinical algorithm based on fetal response have not been tested. Maternal oxygen therapy is often used; however, recent evidence suggests potential risks to the mother and fetus or newborn. Even small increases in maternal and fetal pO(2) as a result of maternal oxygen administration can produce oxygen free radical activity in mothers and fetuses. The potential long-term effects are unknown. Caution should be exercised when considering maternal oxygen administration as a first-line intrauterine resuscitation measure until more data are available, reserving its use after other measures have been unsuccessful in resolving the nonreassuring fetal heart rate pattern.
Labor and Delivery, St. John's Mercy Medical Center, St. Louis, MO, USA. krsimpson@prodigy.net
Kathleen Rice
KR
Simpson
D005260:Female; D005316:Fetal Distress / Q000628:therapy*; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal; D006801:Humans; D007743:Labor, Obstetric; D010102:Oxygen Inhalation Therapy; D011247:Pregnancy; D012151:Resuscitation / Q000379:methods*