Oxygen transfer from mother to fetus during cesarean section under epidural anesthesia

The correlation between maternal PaO2 levels and umbilical vein (UV) and umbilical artery (UA)PO2 levels was studied in 40 healthy patients undergoing elective cesarean sections under lumbar epidural anesthesia. Patients were divided into four equal groups. Each group inhaled oxygen at a FIO2 of 0.21, 0.47, 0.74 (in nitrogen), or 1.0. Maternal arterial samples and fetal UV and UA samples were collected at the time of delivery. Maternal PaO2 levels increased from 96 +/- 4 (1 SE) torr during exposure to to a FIO2 of 0.21 to 232 +/- 6, 312 +/- 16, and 423 +/- 6 torr while breathing FIO2 of 0.47, 0.74 and 1.0, respectively. UV PO2 levels increased from 28 +/- 1 to 36 +/- 1.5, 41 +/- 1.3 and 47 +/- 1.2 torr in the hyperoxic groups. UA PO2 levels increased from 15 +/- 0.7 to 19 +/- 0.8, 21 +/- 0.3, and 25 +/- 1.8 torr, respectively. Oxygen saturation and blood O2 contents increased in maternal and fetal blood. Maternal arterial, UV, and UA base excess values in the hyperoxic groups were significantly higher than in the normoxic groups. There was no difference in 1- or 5-minute Apgar scores between the normoxic and hyperoxic groups. It is concluded that maternal hyperoxia improves fetal oxygen stores and acid-base status during cesarean section under epidural anesthesia.