Intervention Review

Maternal oxygen administration for fetal distress

  1. Bukola Fawole1,*,
  2. G Justus Hofmeyr2

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 23 APR 2008

Assessed as up-to-date: 29 JUN 2007

DOI: 10.1002/14651858.CD000136

Database Title

Additional Information

How to Cite

Fawole B, Hofmeyr GJ. Maternal oxygen administration for fetal distress. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD000136. DOI: 10.1002/14651858.CD000136.

Author Information

  1. 1

    University of Ibadan, Department of Obstetrics and Gynaecology, Ibadan, Nigeria

  2. 2

    University of the Witwatersrand, University of Fort Hare, Eastern Cape Department of Health, Department of Obstetrics and Gynaecology, East London Hospital Complex, East London, Eastern Cape, South Africa

*Bukola Fawole, Department of Obstetrics and Gynaecology, University of Ibadan, College of Medicine, Ibadan, Nigeria. fawoleo@yahoo.co.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 23 APR 2008

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Maternal oxygen administration has been used in an attempt to lessen fetal distress by increasing the available oxygen from the mother. This has been used for suspected fetal distress during labour, and prophylactically during the second stage of labour on the assumption that the second stage is a time of high risk for fetal distress.

Objectives

The objective of this review was to assess the effects of maternal oxygenation for fetal distress during labour and to assess the effects of prophylactic oxygen therapy during the second stage of labour on perinatal outcome.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2007) and the Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 3).

Selection criteria

Randomized trials comparing maternal oxygen administration for fetal distress during labour and prophylactic oxygen administration during the second stage of labour with a control group (dummy or no oxygen therapy).

Data collection and analysis

Both review authors assessed eligibility and trial quality. Data were extracted, checked and entered into Review Manager software. For dichotomous data, we calculated relative risks (RR) and 95% confidence intervals (CI). For continuous data, we calculated weighted mean differences and 95% CI.

Main results

We located no trials addressing maternal oxygen therapy for fetal distress. We included two trials which addressed prophylactic oxygen administration during labour. Abnormal cord blood pH values (less than 7.2) were recorded significantly more frequently in the oxygenation group than the control group (RR 3.51, 95% CI 1.34 to 9.19). There were no other statistically significant differences between the groups. There were conflicting conclusions on the effect of the duration of oxygen administration on umbilical artery pH values between the two trials.

Authors' conclusions

Implications for practice
There is not enough evidence to support the use of prophylactic oxygen therapy for women in labour, nor to evaluate its effectiveness for fetal distress.

Implications for research
In view of the widespread use of oxygen administration during labour and the possibility that it may be ineffective or harmful, there is an urgent need for randomized trials to assess its effects.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Maternal oxygen administration for fetal distress

Too little evidence to show whether oxygen administration to the woman during labour is beneficial to the baby.

Some babies show signs of distress, such as unusual heart rates or the passing of a bowel motion (meconium) during their mother's labour. This may be caused by a lack of oxygen passing from the woman to the baby through the placenta. Sometimes, women may be encouraged to breathe extra oxygen through a facemask (oxygen administration) to increase the oxygen available to the unborn baby. A review of two trials found too little evidence to show whether oxygen administration to the woman during the second stage of labour is beneficial to the baby. No trials of oxygen administration when the baby is showing signs of distress were found. Further research is needed.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

給予孕婦氧氣以改善胎兒窘迫

給予孕婦氧氣以增加體內可利用氧氣被用來減少胎兒窘迫，這樣的方法已經被用於處理分娩期間疑似胎兒窘迫，以及在第二產程預防性使用，因為第二產程被假定是發生胎兒窘迫的高危險期

目標

此文獻回顧的目的是評估在分娩期間供給孕婦氧氣對胎兒窘迫的效用及第二產程給予預防性氧氣治療對生產前後結果的影響

搜尋策略

我們搜尋了the Cochrane Pregnancy and Childbirth Group's Trials Register(2007年6月)以及the Cochrane Central Register of Controlled Trials (The Cochrane Librar 007年，Issue 3)

選擇標準

將分娩期間因胎兒窘迫給予孕婦氧氣和第二產程給予預防性氧氣與控制組(仿作試驗或不給予氧氣)比較的隨機試驗

資料收集與分析

2位回顧作者都評估了適用性與試驗品質。資料選用並檢查過後再輸入文獻回顧處理軟體。對於二分類別資料，我們計算了相對風險(RR)與95% 信賴區間(CI)。對於連續性資料，我們則是計算加權平均差(weighted mean differences)與95% 信賴區間

主要結論

我們沒有找到因胎兒窘迫給予孕婦氧氣治療的試驗，我們納入2個在產程中給予預防性氧氣的試驗。比起對照組，給氧組明顯地較常記錄到不正常之臍帶血pH值(低於7.2)(相對風險3.51，95% 信賴區間1.34 – 9.19)。這兩組之間並沒有統計上的顯著差異。但是這2個試驗之間有關於給予氧氣的時間長短對於臍動脈pH值的影響卻有相反的結論

作者結論

用於實務上的含意: 並沒有足夠的證據支持分娩時給予孕婦預防性的氧氣治療，也不足以評估它對胎兒窘迫的效用。用於研究的含意: 有鑑於分娩期間普遍使用給氧處理和給予氧氣有可能無效或有害，我們急需隨機試驗來評估它的效用

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

太少證據顯示分娩期間給予孕婦氧氣是否對胎兒有幫助。有些嬰兒會表現出窘迫的徵兆，如分娩期間異常心律或解出胎便。這可能是因為缺乏從母親透過胎盤而通往嬰兒的氧氣所引起。有時候醫護人員可能會鼓勵婦女透過面罩來吸入更多的氧氣(給氧處理)以增加胎兒可利用的氧氣量。有1篇包含了2個試驗的文獻回顧發現證據太少不足以證明在第二產程給予孕婦氧氣是否會對嬰兒有好處。目前沒有在胎兒表現窘迫徵兆時給予氧氣的試驗，未來仍需要更進一步的研究

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