Maternal hyperoxygenation for the human fetus: should studies be curtailed?

Congenital hypoplasia of left heart structures in fetuses frequently progresses with gestational development. Interference with cerebral development is common in these fetuses. Chronic maternal hyperoxygenation (MHO) has been recommended to increase left ventricular size and to limit cerebral damage...

Full description

Saved in:
Bibliographic Details
Published in:Pediatric research 2020-03, Vol.87 (4), p.630-633
Main Author: Rudolph, Abraham M.
Format: Article
Language:English
Subjects:
Animals
Aorta, Thoracic - embryology
Brain - blood supply
Brain - embryology
Cerebrovascular Circulation
Disease Models, Animal
Female
Fetuses
Heart
Humans
Hypoplastic Left Heart Syndrome - embryology
Hypoplastic Left Heart Syndrome - physiopathology
Hypoplastic Left Heart Syndrome - therapy
Medicine
Medicine & Public Health
Morphogenesis
Oxygen Inhalation Therapy - adverse effects
Pediatric Surgery
Pediatrics
Pregnancy
Review Article
Risk Assessment
Treatment Outcome
Ventricular Function, Left
Ventricular Remodeling
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Congenital hypoplasia of left heart structures in fetuses frequently progresses with gestational development. Interference with cerebral development is common in these fetuses. Chronic maternal hyperoxygenation (MHO) has been recommended to increase left ventricular size and to limit cerebral damage. The effects of MHO on cerebral blood flow and metabolism have been studied in normal fetuses and fetuses with left heart hypoplasia. Maternal hyperoxygenation increases fetal pulmonary blood flow. This is associated with reduction of foramen ovale flow, thus limiting the increase in left ventricular output. Modest increase in the size of left heart structures has been reported, but in another study, no significant improvement occurred. In sheep fetuses increased oxygenation results in marked reduction of cerebral blood flow, with no change in oxygen delivery or consumption by the brain, but significant reduction in cerebral glucose delivery and consumption. In one study of fetuses with left heart hypoplasia, chronic MHO was associated with decrease in head size. The effectiveness of MHO in improving left ventricular development is controversial. MHO is, however, associated with reduction of cerebral blood flow and possible interference with cerebral development. In view of this it is recommended that all studies of chronic maternal hyperoxygenation be curtailed.
ISSN:0031-3998
1530-0447
DOI:10.1038/s41390-019-0604-4