Maternal oxygen administration for suspected impaired fetal growth.

BACKGROUND Fetal hypoxaemia is often a feature of fetal growth impairment. It has been suggested that perinatal outcome after suspected impaired fetal growth might be improved by giving mothers continuous oxygen until delivery. OBJECTIVES The objective was to assess the effects of maternal oxygen therapy in suspected impaired fetal growth on fetal growth and perinatal outcome. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group trials register (November 2002). SELECTION CRITERIA Acceptably controlled trials comparing maternal oxygen therapy with no oxygen therapy in suspected impaired fetal growth. DATA COLLECTION AND ANALYSIS Eligibility and trial quality was assessed. MAIN RESULTS Three studies involving 94 women were included. Oxygenation compared with no oxygenation was associated with a lower perinatal mortality rate (relative risk: 0.50, 95% confidence interval 0.32 to 0.81). However, higher gestational age in the oxygenation groups may have accounted for the difference in mortality rates. REVIEWER'S CONCLUSIONS There is not enough evidence to evaluate the benefits and risks of maternal oxygen therapy for suspected impaired fetal growth. Further trials of maternal hyperoxygenation seem warranted.

[1]  P. Plsek,et al.  The Vermont Oxford Network: Improving Quality and Safety Through Multidisciplinary Collaboration , 2004 .

[2]  E. J. Coetzee,et al.  A double‐blind randomised controlled trial of continuous oxygen therapy for compromised fetuses , 2002, BJOG : an international journal of obstetrics and gynaecology.

[3]  R. Resnik.  Intrauterine growth restriction. , 2002, Obstetrics and gynecology.

[4]  P. Husslein,et al.  Perinatal mortality and morbidity , 2001, Archives of Gynecology and Obstetrics.

[5]  J. Santolaya-Forgas,et al.  CURRENT CONCEPTS OF FETAL GROWTH RESTRICTION: PART I. CAUSES, CLASSIFICATION, AND PATHOPHYSIOLOGY , 1998, Obstetrics and gynecology.

[6]  J. Huhta,et al.  Reactivity of the human fetal pulmonary circulation to maternal hyperoxygenation increases during the second half of pregnancy: a randomized study. , 1998, Circulation.

[7]  Linna Zhang,et al.  The Effects of Essential Fatty Acids Preparation in the Treatment of Intrauterine Growth Retardation , 1997, American journal of perinatology.

[8]  S. Lindow,et al.  A prospective randomised comparison of the effect of continuous O2, therapy and bedrest on fetuses with absent end‐diastolic flow on umbilical artery Doppler waveform analysis , 1995, British journal of obstetrics and gynaecology.

[9]  A. Genazzani,et al.  Maternal hyperoxygenation in the treatment of mild intrauterine growth retardation: a pilot study , 1994, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[10]  A. Genazzani,et al.  Maternal hyperoxygenation in the treatment of intrauterine growth retardation. , 1992, American journal of obstetrics and gynecology.

[11]  K. Nicolaides,et al.  MATERNAL OXYGEN THERAPY FOR INTRAUTERINE GROWTH RETARDATION , 1987, The Lancet.

[12]  D. Young,et al.  Influence of maternal oxygen administration on the term fetus before labor. , 1980, American journal of obstetrics and gynecology.

[13]  E. Vartiainen,et al.  The Effect of Oxygen Ventilation and A Vasodilator on Uterine Perfusion, Fetal Oxygen and Acid‐Base Balance , 1973 .

[14]  E. Vartiainen,et al.  The Effect of Oxygen Ventilation and a Vasodilator on Uterine Perfusion, Foetal Oxygen and Acid‐Base Balance , 1973, Acta obstetricia et gynecologica Scandinavica.

[15]  E. Holborow.  III.—IMMUNOGLOBULIN PHYSIOLOGY , 1967 .

[16]  G. Badger,et al.  Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction , 2000 .