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Abstract The global increase in cesarean section (CS) rates prompts consideration of factors influencing the decision for CS, including maternal characteristics, medical interventions, and fetal causes. Intrauterine pressure alterations can lead to fetal hypoxia and associated risks. While neonatal resuscitation with 100% oxygen may have adverse effects, maternal hyperoxygenation during the second stage of labor shows positive effects on fetal heart rate. Maternal oxygen supplementation is commonly used for intrauterine resuscitation, but its impact on neonatal outcomes, especially umbilical artery pH, remains inconclusive. Therfore, our study investigated the impact of supplemental oxygen during elective cesarean section (CS) under spinal anesthesia on neonatal outcomes. The study followed ethical standards, obtaining informed consent and approval from the ethics committee at Benha Faculty of Medicine. Inclusion criteria involved mothers aged 20-40, carrying a single full-term fetus (≥37 weeks), and undergoing elective Caesarean section with spinal anesthesia. Exclusion criteria included factors like major fetal anomalies, multiple gestations, suspected infection during labor, preterm births, congenital malformations, and prolonged bradycardia in infants. Mothers with certain medical conditions and those undergoing emergency Caesarean sections were also excluded. The careful ethical considerations and inclusion/exclusion criteria ensured participant safety and research integrity, emphasizing the study’s commitment to sound practices in investigating elective Caesarean sections under spinal anesthesia |