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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

doi: 10.1097/AOG.0b013e318297ec6c
Original Research

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.



Supplemental perioperative oxygen does not decrease the rate of surgical site wound infection or endometritis after cesarean delivery.

Departments of Obstetrics and Gynecology, Santa Clara Valley Medical Center, San Jose, California, and Oregon Health and Science University, Portland, Oregon.

Corresponding author: Neena Duggal, MD, Department of Obstetrics and Gynecology, Santa Clara Valley Medical Center, 751 S Bascom Avenue, San Jose, CA 95128; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented at the Society for Maternal-Fetal Medicine 31st Annual Meeting, February 7–12, 2011, San Francisco, California.

© 2013 by The American College of Obstetricians and Gynecologists.