Is It Safe to Use Oxygen While Pregnant? A Comprehensive Guide

Introduction

The use of supplemental oxygen during pregnancy and labor has been a topic of debate in the medical community for years. While it's a common practice in many hospitals, recent research has called into question its routine use for healthy pregnant women. This article will explore the safety and efficacy of oxygen use during pregnancy, examining both potential benefits and risks.

Understanding Oxygen Use in Pregnancy

Oxygen administration during pregnancy is typically done for two main reasons:

1. To improve fetal oxygenation in cases of suspected fetal distress
2. As a prophylactic measure during labor or cesarean sections

The theory behind this practice is that increasing maternal oxygen levels will lead to better oxygen transfer to the fetus. However, recent studies have challenged this assumption.

Safety of Oxygen Use in Normal Pregnancies

For low-risk pregnancies and normal labor, the evidence does not support routine oxygen supplementation. A systematic review by Chatmongkolchart et al. (2016) found no significant differences in Apgar scores at one and five minutes between newborns whose mothers received supplemental oxygen and those who didn't during elective cesarean sections.

Moreover, a study by Chuai et al. (2022) showed that long-duration, high-concentration oxygen administration during labor did not affect umbilical cord venous partial pressure of oxygen or fetal heart rate patterns. Surprisingly, it resulted in lower umbilical cord arterial pH at birth, suggesting potential negative effects.

Oxygen Use in High-Risk Pregnancies

While routine use in normal pregnancies is questionable, oxygen therapy may have benefits in certain high-risk situations. For instance, Van Hoesen et al. (1989) reported successful treatment of acute carbon monoxide poisoning during pregnancy using hyperbaric oxygen therapy.

In cases of fetal distress or complicated pregnancies, oxygen therapy might be beneficial. However, Deng et al. (2021) emphasize the need for large randomized controlled trials to support widespread application in these contexts.

Potential Risks and Concerns

While oxygen therapy is generally considered safe, there are some potential risks to consider:

• Increased free radical activity: Chatmongkolchart et al. (2013) found higher levels of oxygen free radicals in mothers and newborns who received supplemental oxygen.
• Possible vasoconstriction: Abati et al. (2023) suggest that hyperoxia might cause time-dependent vasoconstriction of umbilical and placental vessels.
• Potential for reperfusion injury: In cases of fetal hypoxia, rapid reoxygenation could theoretically worsen reperfusion injury, although more research is needed to confirm this.

Current Recommendations

Based on the available evidence, current recommendations include:

1. Avoid routine oxygen supplementation for low-risk pregnancies and normal labor.
2. Reserve oxygen therapy for cases of maternal hypoxia or specific high-risk situations.
3. When oxygen is necessary, use the lowest effective concentration for the shortest duration possible.
4. Consider individual patient factors and consult with healthcare providers for personalized recommendations.

Conclusion

While oxygen therapy can be life-saving in certain situations, its routine use during pregnancy and labor is not supported by current evidence. The safety of oxygen use during pregnancy depends largely on the specific circumstances and should be evaluated on a case-by-case basis. As research in this area continues to evolve, it's crucial for expectant mothers to discuss any concerns about oxygen use with their healthcare providers to ensure the best possible outcomes for both mother and baby.