A simulation model to study maternal hyperoxygenation during labor

作者：Bullens Lauren M^*; van der Hout van der Jagt Marieke B; Heimel Pieter J Van Runnard; Oei Guid

来源：Acta Obstetricia et Gynecologica Scandinavica, 2014, 93(12): 1268-1275.

DOI：10.1111/aogs.12486

• Fetal heart rate
• obstetric labor
• computer simulation
• model
• maternal hyperoxygenation
• intrauterine resuscitation
• fetal distress
• translational medical research

ObjectiveTo investigate the effect of maternal hyperoxygenation on fetal oxygenation and fetal heart rate decelerations during labor, using a simulation model. %26lt;br%26gt;DesignUse of a mathematical model that simulates feto-maternal hemodynamics and oxygenation, designed in Matlab R2012a. %26lt;br%26gt;SettingClinical and engineering departments in the Netherlands. %26lt;br%26gt;MethodsWe simulated variable and late fetal heart rate decelerations, caused by uterine contractions with a different contraction interval. We continuously recorded oxygen pressure in different feto-placental compartments and fetal heart rate, during maternal normoxia and during hyperoxygenation with 100% oxygen. %26lt;br%26gt;Main outcome measuresChanges in oxygen pressure in the intervillous space, umbilical vein and arteries, fetal cerebral and microcirculation as well as fetal heart rate deceleration depth and duration. %26lt;br%26gt;ResultsMaternal hyperoxygenation leads to an increase in fetal oxygenation: in the presence of variable decelerations, oxygen pressure in the intervillous space increased 9-10mmHg and in the cerebral circulation 1-2mmHg, depending on the contraction interval. In addition, fetal heart rate deceleration depth decreased from 45 to 20beats per minute. In the presence of late decelerations, oxygen pressure in the intervillous space increased 7-10mmHg and in the cerebral circulation 1-2mmHg, depending on the contraction interval. The fetus benefited more from maternal hyperoxygenation when contraction intervals were longer. %26lt;br%26gt;ConclusionsAccording to the simulation model, maternal hyperoxygenation leads to an increase in fetal oxygenation, especially in the presence of variable decelerations. In addition, in the presence of variable decelerations, maternal hyperoxygenation leads to amelioration of the fetal heart rate pattern.

• 出版日期2014-12