The Newborn Outcomes Following HFNCO in Term Parturients Undergoing Caesarean Section: A Prospective Randomized Study

Objective: High-flow nasal oxygenation (HFNO) is a well-established preoxygenation technique in non-pregnant patients.However, its efficacy in term parturients remains uncertain, with some studies reporting suboptimal results.Moreover, data on neonatal outcomes in this population are limited.To evaluate the effects of HFNO on neonatal outcomes in parturients undergoing cesarean section under general anesthesia, focusing on Apgar scores as the primary outcome and umbilical cord venous blood gas parameters as the secondary outcome.Methods: Following Ethics Committee approval and clinical trial registration (NCT03903003), 102 term parturients were randomized into two groups: HFNO (n=50) and conventional face mask preoxygenation (n=52).The HFNO group received oxygen at 60 L/min, while the conventional group received 100% oxygen at 10 L/min.Induction was initiated once end-tidal oxygen (etO) reached 90%, and oxygenation continued during intubation.Neonatal Apgar scores at 1 and 5 minutes, umbilical cord venous blood gas values, and maternal hemodynamic parameters were recorded. Results:The HFNO group showed significantly higher Apgar scores at both 1 minute (9 (3-10) vs. 8 (3-10); p<0.001) and 5 minutes (10 (7-10) vs. 10 (4-10); p<0.001) compared to the conventional group.Cord venous blood gas parameters were comparable between the groups. Conclusion:HFNO use for preoxygenation before and during induction in parturients undergoing cesarean section improved neonatal Apgar scores compared to conventional face mask oxygenation.These findings support HFNO as a safe and effective preoxygenation method in obstetric anesthesia.