Key result
Short-term maternal hyperoxygenation safely aids fetal circulation testing, but chronic therapy requires longer neurological follow-up.
Why the study?
Does maternal hyperoxygenation improve the assessment of fetal hemodynamics and provide therapeutic benefit in fetuses with cardiovascular or growth abnormalities?
Does maternal hyperoxygenation improve the assessment of fetal hemodynamics and provide therapeutic benefit in fetuses with cardiovascular or growth abnormalities?
Maternal hyperoxygenation is a safe and potentially useful short-term diagnostic test for assessing fetal hemodynamics and pulmonary vasoreactivity, though its use as a chronic therapy requires further investigation due to potential neurological risks.
Short-term maternal hyperoxygenation may aid perinatal stratification; leaves open chronic fetal therapy safety pending extended pediatric and neurological data.
Twenty-nine publications about maternal hyperoxygenation (MHO) were reviewed: 20 discussing MHO as a diagnostic test used by obstetricians (in SGA/IUGR, preeclampsia, fetuses with diaphragmatic hernia, healthy fetuses) and fetal cardiologists (in HLHS, Ebstein, lung hypoplasia, diaphragmatic hernia).Maternal hyperoxygenation was used for 8-20 min, and out of 13 obstetrical publications 8 provided positive effects for stratification of perinatal management.Seven of the fetal cardiology publications were positive.Nine publications dealing with MHO as a transplacental treatment presented positive results in 7, in 1 there was suggestion for necessity for postnatal follow-up with head circumference measurements during postnatal life, and 1 paper (review) suggested that MHO should be curtailed.Based on the current literature, it can be concluded that MHO has no harmful effect when used in the short term for testing.Longer paediatric and neurological follow-up is needed when used chronically as a fetal therapy.Institutional Review Board approval is recommended as well as informed consent.Maternal hyperoxygenation as a test might be a useful for testing the fetal circulation, and it gives insight into fetal CV physiology and during transition and might be helpful for the better stratification for perinatal care in fetuses with selected heart defects.Assessment of blood flow and cardiovascular status during MHO by fetal echocardiography in the 3 rd trimester is challenging and requires a high level of expertise.Optimally it should be performed in fetal cardiac centres.
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Respondek‐Liberska et al. (2021) conducted a review in Fetal cardiovascular and pulmonary conditions (n=29). Maternal hyperoxygenation vs. Baseline or room air was evaluated on Utility and safety of maternal hyperoxygenation. Maternal hyperoxygenation has no harmful effect when used short-term for testing fetal circulation and may aid in perinatal care stratification, but chronic use as fetal therapy requires longer pediatric and neurological follow-up.
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