Efficacy of intrauterine resuscitation techniques in improving fetal oxygen status during labor.

OBJECTIVE

To evaluate the efficacy of 3 common intrauterine resuscitation techniques used during labor.

METHODS

Intrauterine resuscitation techniques were prospectively evaluated in healthy women during labor. Forty-two women were randomized to either a 500-mL or 1,000-mL intravenous (IV) fluid bolus over 20 minutes. Fifty-one women were randomized to 1 of 6 position sequences including supine with the head elevated 30 degrees , left lateral and right lateral for 15 minutes each in succession. Forty-nine women received 10 L/min of oxygen (O(2)) via nonrebreather face mask for 15 minutes. Differences in fetal oxygen saturation (FSpO(2)) were evaluated before, during, and after each intervention.

RESULTS

An IV fluid bolus of 1,000 mL had a greater effect on FSpO(2) than an IV fluid bolus of 500 mL (500 mL: mean increase 3.7; 1,000 mL: mean increase 5.2; P = .05). Fetal oxygen saturation was higher in a lateral position (left mean 48.3%, right mean 47.7%) than in a supine position (mean supine 37.5%, P = .03). Oxygen administration increased FSpO(2) (mean increase 8.7, P = .03). The effect persisted for more than 30 minutes after the O(2) was discontinued (P = .03). For fetuses with FSpO(2) less than 40% before maternal O(2) administration, the increase was greater (mean increase 11.4) than for those with FSpO(2) of 40% or greater (mean increase 7.6, P = .03).

CONCLUSION

An intravenous fluid bolus of 1,000 mL, lateral positioning, and O(2) administration at 10 L/min via nonrebreather face mask are effective in increasing FSpO(2) during labor.