REVIEW
Maternal hyperoxygenation during pregnancy as a tool in fetal disease diagnosis and treatment
Agnieszka Zalinska,
Maria Respondek-Liberska,
Maciej Slodki,
Agnieszka Zalinska
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
Department of Obstetrics and Perinatology, Chair of Obstetrics, Gynecology and Oncological Gynecology, Medical University of Lodz, Lodz, Poland
Search for more papers by this authorMaria Respondek-Liberska
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
Department of Diagnosis and Prevention of Fetal Malformations, Medical University of Lodz, Lodz, Poland
Search for more papers by this authorCorresponding Author
Maciej Slodki
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
Faculty of Health Sciences, The Mazovian State University, Plock, Poland
Correspondence
Maciej Slodki, Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.
Email: [email protected]
Search for more papers by this authorAgnieszka Zalinska,
Maria Respondek-Liberska,
Maciej Slodki,
Agnieszka Zalinska
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
Department of Obstetrics and Perinatology, Chair of Obstetrics, Gynecology and Oncological Gynecology, Medical University of Lodz, Lodz, Poland
Search for more papers by this authorMaria Respondek-Liberska
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
Department of Diagnosis and Prevention of Fetal Malformations, Medical University of Lodz, Lodz, Poland
Search for more papers by this authorCorresponding Author
Maciej Slodki
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
Faculty of Health Sciences, The Mazovian State University, Plock, Poland
Correspondence
Maciej Slodki, Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.
Email: [email protected]
Search for more papers by this authorAbstract
Maternal hyperoxygenation (MHO) consists of giving pregnant women (60% to 100%) oxygen through a facemask and using ultrasound assess or monitor the influence on fetal cardiovascular circulation. This review discusses the findings and the utility of acute and chronic MHO in various fetal diseases.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
REFERENCES
- 1Respondek-Liberska M, Donofrio M. Maternal hyperoxygenation in prenatal ultrasound and fetal echocardiography–literature review 2020. Prenat Cardio. 2021; 11(1): 5-12.
- 2Szwast A, Tian Z, McCann M, Donaghue D, Rychik J. Vasoreactive response to maternal hyperoxygenation in the fetus with hypoplastic left heart syndrome. Circ Cardiovasc Imaging. 2010; 3: 172-178.
- 3Enzensberger C, Axt-Fliedner R, Degenhardt J, et al. Pulmonary vasoreactivity to materno-fetal hyperoxygenation testing in fetuses with hypoplastic left heart. Ultraschall Med. 2016; 37: 195-200.
- 4Kohl T. Chronic intermittent materno-fetal hyperoxygenation in late gestation may improve on hypoplastic cardiovascular structures associated with cardiac malformations in human fetuses. Pediatr Cardiol. 2010; 31: 250-263.
- 5Kohl T. Effects of maternal-fetal hyperoxygenation on aortic arch flow in a late-gestation human fetus with closed oval foramen at risk for coarctation. J Thorac Cardiovasc Surg. 2011; 142: e67-e69.
- 6Zeng S, Jiawei Z, Qinghai P, et al. Sustained maternal hyperoxygenation improves aortic arch dimensions in fetuses with coarctation. Sci Rep. 2016; 6:39304.
- 7Zeng S, Zhou J, Peng Q, et al. Sustained chronic maternal Hyperoxygenation increases myocardial deformation in fetuses with a small aortic isthmus at risk for coarctation. J Am Soc Echocardiogr. 2017; 30(10): 992-1000.
- 8Lara DA, Morris SA, Maskatia SA, et al. Pilot study of chronic maternal hyperoxygenation and effect on aortic and mitral valve annular dimensions in fetuses with left heart hypoplasia. Ultrasound Obstet Gynecol. 2016; 48: 365-372.
- 9Channing A, Szwast A, Natarajan S, Degenhardt K, Tian Z, Rychik J. Maternal hyperoxygenation improves left heart filling in fetuses with atrial septal aneurysm causing impediment to left ventricular inflow. Ultra- Sound Obstet Gynecol. 2015; 45: 664-669.
- 10Szwast A, Putt M, Gaynor JW, Licht DJ, Rychik J. Cerebrovascular response to maternal hyperoxygenation in fetuses with hypoplastic left heart syndrome depends on gestational age and baseline cerebrovascular resistance. Ultrasound Obstet Gynecol. 2018; 52: 473-478.
- 11Hogan WJ, Moon-Grady AJ, Zhao Y, et al. Fetal cerebrovascular response to maternal hyperoxygenation in congenital heart disease: effect of cardiac physiology. Ultrasound Obstet Gynecol. 2021; 57(5): 769-775.
- 12Nicolaides KH, Campbell S, Bradley RJ, Bilardo CM, Soothill PW, Gibb D. Maternal oxygen therapy for intrauterine growth retardation. Lancet. 1987; 8539: 942-945.
10.1016/S0140-6736(87)90292-3 Google Scholar
- 13Arduini D, Rizzo G, Romanini C, Mancuso S. Fetal hemodynamic response to acute maternal hyperoxygenation as predictor of fetal distress in intrauterine growth retardation. BMJ. 1989; 298: 1561-1562.
- 14Rizzo G, Arduini D, Romanini C, Mancuso S. Doppler echocardiographic assessment of time to peak velocity in the aorta and pulmonary artery of small for gestational age fetuses. Br J Obstet Gynaecol. 1990; 97: 603-607.
- 15de Rochambeau B, Poix D, Mellier G. Maternal hyperoxygenation: a fetal blood flow velocity prognosis test in small-for-gestational-age fetuses? Ultrasound Obstet Gynecol. 1992; 2(4): 279-282.
- 16Battaglia C, Artini PG, D'Ambrogio G, Galli PA, Segre A, Genazzani AR. Maternal hyperoxygenation in the treatment of intrauterine growth retardation. Am J Obstet Gynecol. 1992; 167: 430-435.
- 17Caforio L, Caruso A, Testa AC, Pompei A, Ciampelli M. Short-term maternal oxygen administration in fetuses with absence or reversal of end- diastolic velocity in umbilical artery: pathophysiological and clinical considerations. Acta Obstet Gynecol Scand. 1998; 77: 707-711.
- 18Brantberg A, Sonesson SE. Central arterial hemodynamics in small for gestational age fetuses before and during maternal hyperoxygenation: a Doppler velocimetric study with particular attention to the aortic isthmus. Ultrasound Obstet Gynecol. 1999; 14: 237-243.
- 19Khatib N, Thaler I, Beloosesky R, et al. The effect of maternal hyperoxygenation on fetal circulatory system in normal growth and IUGR fetuses. What we can learn from this impact. Fetal Neonatal Med. 2018; 31: 914-918.
- 20Schidlow DN, Donofrio MT. Prenatal maternal hyperoxygenation testing and implications for critical care delivery planning among fetuses with congenital heart disease: early experience. Am J Perinatol. 2018; 35: 16-23.
- 21Mardy C, Kaplinski M, Peng L, et al. Maternal hyperoxygenation testing in fetuses with hypoplastic left-heart syndrome: association with postnatal atrial septal restriction. Fetal Diagn Ther. 2021; 48(9): 678-689.
- 22Broth RE, Wood DC, Rasanen J, et al. Prenatal prediction of lethal pulmonary hypoplasia: the hyperoxygenation test for pulmonary artery reactivity. Am J Obstet Gynecol. 2002; 187: 940-945.
- 23Done E, Allegaert K, Lewi P, et al. Maternal hyperoxygenation test in fetuses undergoing FETO for severe isolated congenital diaphragmatic hernia. Ultrasound Obstet Gynecol. 2011; 37: 264-271.
- 24Żarkowska-Szaniawska A, Janiak K, Foryś S, Słodki M, Respondek-Liberska M. Maternal hyperoxygenation test in prediction of fetal lung hypoplasia – preliminary report. Ginekol pol. 2011; 82: 834-839.
- 25Edwards LA, Lara DB, Sanz Cortes M, et al. Chronic maternal hyperoxygenation and effect on cerebral and placental vasoregulation and neurodevelopment in fetuses with left heart hypoplasia. Fetal Diagn Ther. 2019; 46: 45-57.
- 26Ribbert LS, van Lingen RA, Visser GH. Continuous maternal hyperoxygenation in the treatment of early fetal growth retardation. Ultrasound Obstet Gynecol. 1991; 1(5): 331-335.
- 27Battaglia C, Artini PG, D'Ambrogio G, Bencini S, Galli PA, Genazzani AR. Maternal hyperoxygenation in the treatment of mild intrauterine growth retardation: a pilot study. Ultrasound Obstet Gynecol. 1994; 4: 472-475.
- 28Johanson R, Lindow SW, Elst C, Jaquire Z, Westhuizen S, Tucker A. A prospective randomized comparison of the effect of continuous O2 therapy and bedrest on fetuses with absent end-diastolic flow on umbilical artery Doppler waveform analysis. Br J Obstet Gynaecol. 1995; 102: 662-665.
- 29Lindow S, Mantel G, Anthony J, Coetzee E, Pharoah P. A double blind randomized controlled trial of continuous oxygen therapy for compromised fetuses. J Perinat Med. 2001; 29(1): 123.
- 30Kirschbaum TH, Lucas WE, Dehaven JC, Assali NS. Dynamics of placental oxygen transfer: I. effects of maternal hyperoxia in pregnant ewes and fetal iambs. Am J Obstet Gynecol. 1967; 98: 429.
- 31Assali NS, Kirschbaum TH, Dilts PV. Effects of hyperbaric oxygen on uteroplacental and fetal circulation. Circ Res. 1968; 22(5): 573-588.
- 32Morin FC 3rd, Egan EA. Pulmonary hemodynamics in fetal lambs during development at normal and increased oxygen tension. J Appl Physiol. 1985; 73(1): 213-218.
- 33Morin FC 3rd, Egan EA, Ferguson W, Lundgren CE. Development of pulmonary vascular response to oxygen. Am J Physiol. 1988; 254(3 Pt 2): H542-H546.
- 34Rasanen J, Wood DC, Debbs RH, Cohen J, Weiner S, Huhta JC. Reactivity of the human fetal pulmonary circulation to maternal hyperoxygenation increases during the second half of pregnancy: a randomized study. Circulation. 1998; 97: 257-262.
- 35McHugh A, El-Khuffash A, Franklin O, Breathnach FM. Calling into question the future of hyperoxygenation in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2021; 258: 93-97.
- 36Hamzah M, Othman HF, Baloglu O, Aly H. Outcomes of hypoplastic left heart syndrome: analysis of national inpatient sample database 1998–2004 versus 2005–2014. Eur J Pediatr. 2020; 179(2): 309-316.
- 37Schneider K, Hahn E, Statile C, et al. Pulmonary venous Doppler patterns and midterm outcomes in fetuses with left-sided obstructive lesions and restrictive atrial septum. Prenat Diagn. 2020; 40(7): 776-784.
- 38Michelfelder E, Gomez C, Border W, Gottliebson W, Franklin C. Predictive value of fetal pulmonary venous flow patterns in identifying the need for atrial septoplasty in the newborn with hypoplastic left ventricle. Circulation. 2005; 112(19): 2974-2979.
- 39Sokolowski L, Respondek-Liberska M, Pietryga M, Slodki M. Prenatally diagnosed foramen ovale restriction in fetuses with hypoplastic left heart syndrome may be a predictor of longer hospitalization, but not of a need for an urgent rashkind procedure. Ginekol pol. 2019; 90(1): 31-38.
- 40Bilardo CM, Snijders RM, Campbell S, Nicolaides KH. Doppler study of the fetal circulation during long-term maternal hyperoxygenation for severe early onset intrauterine growth retardation. Ultrasound Obstet Gynecol. 1991; 1(4): 250-257.
- 41Say L, Gülmezoglu AM, Hofmeyr GJ. Maternal oxygen administration for suspected impaired fetal growth. Cochrane Database Syst Rev. 2003;(1):CD000137. doi:10.1002/14651858.CD000137
- 42McHugh A, Breatnach C, Bussmann N, Franklin O, El-Khuffash A, Breathnach FM. Prenatal prediction of neonatal hemodynamic adaptation after maternal hyperoxygenation. BMC Pregnancy Childbirth. 2020; 20(1): 706.
- 43O'Driscoll BR, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax. 2008; 63(6): vi1-vi68.
- 44Deng Y, Jin Y, Xu R, Zeng S. Fetal hemodynamic response to maternal oxygenation in normal and complicated pregnancies. Ultraschall Med. 2021; 42(6): 607-613.
- 45Lee FT, Marini D, Seed M, Sun L. Maternal hyperoxygenation in congenital heart disease. Transl Pediatr. 2021; 10(8): 2197-2209.
- 46Co-Vu J, Lopez-Colon D, Vyas HV, Weiner N, DeGroff C. Maternal hyperoxygenation: A potential therapy for congenital heart disease in the fetuses? A systematic review of the current literature. Echocardiography. 2017; 34(12): 1822-1833.
Citing Literature
