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Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e318297ec6c
Original Research

Perioperative Oxygen Supplementation and Surgical Site Infection After Cesarean Delivery: A Randomized Trial

Duggal, Neena MD; Poddatorri, Vineela MD; Noroozkhani, Sara MD; Siddik-Ahmad, R. Iram MD; Caughey, Aaron B. MD, PhD

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Abstract

OBJECTIVE: To evaluate whether supplemental perioperative oxygen decreases surgical site wound infections or endometritis.

STUDY DESIGN: This was a prospective, randomized trial. Patients who were to undergo cesarean delivery were recruited and randomly allocated to either 30% or 80% oxygen during the cesarean delivery and for 1 hour after surgery. The obstetricians and patients were blinded to the concentration of oxygen used. Patients were evaluated for wound infection or endometritis during their hospital stay and by 6 weeks postpartum. The primary end point was a composite of either surgical site infection or endometritis.

RESULTS: Eight hundred thirty-one patients were recruited. Of these, 415 participants received 30% oxygen perioperatively and 416 received 80% oxygen. The groups were well matched for age, race, parity, diabetes, number of previous cesarean deliveries, and scheduled compared with unscheduled cesarean deliveries. An intention-to-treat analysis was used. There was no difference in the primary composite outcome (8.2% in women who received 30% oxygen compared with 8.2% in women who received 80% oxygen, P=.89), no difference in surgical site infection in the two groups (5.5% compared with 5.8%, P=.98), and no significant difference in endometritis in the two groups (2.7% compared with 2.4%, P=.66), respectively.

CONCLUSION: Women who received 80% supplemental oxygen perioperatively did not have a lower rate of a surgical site infection or endometritis as compared with women who received 30% supplemental oxygen concentration.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clincaltrials.gov, NCT00876005.

LEVEL OF EVIDENCE: I

© 2013 by The American College of Obstetricians and Gynecologists.

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