Jozwik M, Sledziewski A, Klubowicz Z, Zak J, Sajewska G, Pietrzycki B
Zaklad Rozwoju Plodu i Noworodka IMD w Bialymstoku, ul. M. Sklodowskiej - Curie, 15-267 Bialystok.
Med Wieku Rozwoj. 2000 Oct-Dec;4(4):403-11.
The effect of supplemental maternal oxygen therapy on acid-base status has for years been a subject of controversies. There is still no general agreement about oxygen administration in pregnancy or in labour. Many clinicians believe that in normal pregnancy maternal oxygen treatment has merely negligible, if any, influence on the foetus. Maternal oxygen therapy has frequently been suggested when oxygen supply to the foetus was insufficient, viz. in antepartum or intrapartum hypoxia. The aim of this study was to determine whether a brief maternal hyperoxygenation during caesarean section or during the second stage of normal delivery affects cord blood acid-base status measured at birth. Patients with uneventful term pregnancy admitted to the delivery room in spontaneous labour or indicated for elective caesarean section were matched and prospectively ascribed to the control or treatment group. The latter received 60% oxygen for ca. 10 min at 15 L/min by a face mask. We studied 41 normal term infants of healthy mothers (24 from caesarean sections, the remaining 17 delivered vaginally). The control group consisted of normal newborns chosen according to the same criteria except that their mothers had no oxygen supplementation. Immediately after delivery, umbilical cord paired blood samples were drawn. Arterial and venous specimens were analysed for blood gases and acid-base balance parameters. Statistical analysis assisted by computer software was performed using Mann-Whitney U test. A p value < 0.05 was considered significant. All tested parameters related to the acid-base status and blood gases were similar in the treatment and control groups. Concluding, a short period of maternal hyperoxygenation either in the second stage of vaginal spontaneous delivery or during caesarean section did not affect umbilical cord blood acid-base status measured at birth.
多年来,孕产妇补充氧气疗法对酸碱平衡状态的影响一直存在争议。对于孕期或分娩时的氧气供应,目前仍未达成普遍共识。许多临床医生认为,在正常妊娠中,孕产妇吸氧治疗即使有影响,对胎儿的影响也微乎其微。当胎儿氧气供应不足时,即在产前或产时缺氧时,常常建议进行孕产妇吸氧治疗。本研究的目的是确定剖宫产或正常分娩第二产程中短暂的孕产妇高氧血症是否会影响出生时测量的脐血酸碱平衡状态。将自然临产或择期剖宫产入住产房的足月妊娠情况良好的患者进行匹配,并前瞻性地分为对照组或治疗组。治疗组通过面罩以15L/min的流量吸入约60%的氧气10分钟左右。我们研究了41名健康母亲的足月正常婴儿(24名剖宫产,其余17名经阴道分娩)。对照组由根据相同标准选择的正常新生儿组成,只是其母亲未进行氧气补充。分娩后立即采集脐血配对样本。对动脉和静脉样本进行血气和酸碱平衡参数分析。使用Mann-Whitney U检验并借助计算机软件进行统计分析。p值<0.05被认为具有统计学意义。治疗组和对照组中所有与酸碱平衡状态和血气相关的测试参数均相似。总之,阴道自然分娩第二产程或剖宫产期间短时间的孕产妇高氧血症不会影响出生时测量的脐血酸碱平衡状态。