When a baby appears to be in distress during labor, nurses and doctors use several techniques intended to improve the baby’s oxygen level. Now, researchers have shown that three commonly used measures do indeed work.
As reported in the medical journal Obstetrics & Gynecology, these techniques involve giving the mother a liter of IV fluid, placing her on her side, and administering oxygen with a face mask.
In fact, these steps “have become the legal standard,” said Dr. Kathleen Rice Simpson, from St. John’s Mercy Medical Center in St. Louis. “If you don’t use them when the fetus is in trouble, people will say that you’ve violated the standard of care.”
Ironically, “There isn’t a lot of evidence to support these measures,” Dr. Simpson said. “They’re just intuitively thought to benefit the fetus.”
To put the practices on a more scientific basis, Simpson and her colleague Dr. Dotti C. James studied the effects of IV fluid, positioning, and oxygen administration on the oxygen status of the babies of 54 women in labor.
All of the women were healthy, and their babies weren’t in obvious distress - because if they had been it would have been unethical to test the oxygen-boosting techniques by withholding them in some cases.
Giving a liter of IV fluid was significantly better than half a liter at improving fetal oxygen saturation, the investigators found. Likewise, lateral positioning and oxygen administration also significantly improved the babies’ oxygen level.
“I had expected O2 use to be beneficial, but I was surprised that the IV fluid bolus also worked,” Simpson noted.
Although the study involved non-distressed infants, Simpson said she expected the improvement in oxygenation to be even more pronounced for babies in difficulties. Her team is now planning a study in such situations, she said, given the positive results of the current study.
SOURCE: Obstetrics & Gynecology, June 2005.
Revision date: July 7, 2011
Last revised: by Jorge P. Ribeiro, MD