Intrapartum Maternal Oxygen Supplementation: Effects on the Mother and Neonate



Status:Recruiting
Healthy:No
Age Range:18 - Any
Updated:10/26/2018
Start Date:July 15, 2018
End Date:October 30, 2020
Contact:Nandini Raghuraman, MD MS
Email:nraghuraman@wustl.edu
Phone:314 273 2939

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Approximately 2/3 of laboring women receive supplemental oxygen (O2) in an attempt to reverse
perceived fetal hypoxia on electronic fetal monitoring (EFM). O2 supplementation is most
commonly used in patients with Category II EFM, a class of EFM patterns designed in part to
identify fetal acidemia. This liberal use of O2 in laboring patients is concerning because
hyperoxygenation in infants is associated with adverse outcomes including retinopathy and
abnormal neurodevelopment. Furthermore, excess O2 exposure is linked to free radical
generation and subsequent oxidative cell damage. This calls for a closer look at the safety
of intrauterine O2 exposure. The proposed project explores potential mechanisms for harm with
maternal O2 supplementation in laboring patients with Category II EFM. Specifically, this
project will determine the effect of O2, compared to room air (RA), on umbilical cord and
maternal levels of malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE), markers of free
radical-induced oxidative stress. The study will also explore the potential effect of
peripartum O2 exposure on placental oxidative stress. We will also use magnetic resonance
imaging to investigate the effect of in utero hyperoxygenation on the neonatal brain.


Inclusion Criteria:

- Singleton

- Gestational age ≥37 weeks

- Spontaneous labor or induction of labor

- English speaking

- Ability to give informed consent

Exclusion Criteria:

- Major fetal anomaly

- Multiple gestation

- Category III electronic fetal monitoring

- Maternal hypoxia

- Preeclampsia

- Intrauterine growth restriction

- Pregestational diabetes
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