A double-blinded randomized controlled trial on the effects of increased intravenous hydration in nulliparas undergoing induction of labor - 20/07/22
, Erica Wu, MD b, Alex Fong, MD c, Thomas J. Garite, MD a, Vineet K. Shrivastava, MD dAbstract |
Background |
Rates of labor induction are increasing, raising concerns related to increased healthcare utilization costs. High-dose intravenous fluid (250 cc/h) has been previously demonstrated to shorten the time to delivery in nulliparous individuals in spontaneous labor. Whether or not this relationship exists among individuals undergoing induction of labor is unknown.
Objective |
Our study aimed to evaluate the effect of high-dose intravenous hydration on time to delivery among nulliparous individuals undergoing induction of labor.
Study Design |
Nulliparous individuals presenting for induction of labor with a Bishop score of ≤6 (with and without rupture of membranes) were randomized to receive either 125 cc/h or 250 cc/h of normal saline. The primary outcome was length of labor (defined as time from initiation of study fluids to delivery). Both time to overall delivery and vaginal delivery were evaluated. Secondary outcomes included the lengths of each stage of labor, the percentage of individuals delivering within 24 hours, and maternal and neonatal outcomes, including cesarean delivery rate.
Results |
A total of 180 individuals meeting inclusion criteria were enrolled and randomized. Baseline demographic characteristics were similar between groups; however, there was a higher incidence of diabetes mellitus in the group receiving 125 cc/h. Average length of labor was similar between groups (27.6 hours in 250 cc/h and 27.8 hours in 125 cc/h), as was the length of each stage of labor. Cox regression analysis did not demonstrate an effect of fluid rate on time to delivery. Neither the admission Bishop score, body mass index, nor other demographic characteristics affected time to delivery or vaginal delivery. There were no differences in maternal or neonatal outcomes, including overall cesarean delivery rate, clinically apparent iatrogenic intraamniotic infection, Apgar scores, need for neonatal phototherapy, or neonatal intensive care unit stay.
Conclusion |
There were no observed differences in the length of labor or maternal or neonatal outcomes with the administration of an increased rate of intravenous fluids among nulliparous individuals undergoing induction of labor.
Le texte complet de cet article est disponible en PDF.Key words : hydration, induction, intravenous fluids, labor, labor duration, nullipara, obstetrics, pregnancy
Plan
| The authors report no conflict of interest. |
|
| This study was funded through the Memorial Foundation, which did not have any role in participant enrollment, data collection or analysis, or manuscript preparation or submission. |
|
| Cite this article as: Duffy JY, Wu E, Fong A, et al. A double-blinded randomized controlled trial on the effects of increased intravenous hydration in nulliparas undergoing induction of labor. Am J Obstet Gynecol 2022;227:269.e1-7. |
Vol 227 - N° 2
P. 269.e1-269.e7 - août 2022 Retour au numéro
Article précédent
- On the management of maternal pushing during the second stage of labor: a biomechanical study considering passive tissue fatigue damage accumulation
- Maria C.P. Vila Pouca, João P.S. Ferreira, Marco P.L. Parente, Renato M. Natal Jorge, James A. Ashton-Miller
- Arabin pessary to prevent adverse perinatal outcomes in twin pregnancies with a short cervix: a multicenter randomized controlled trial (PESSARONE)
- Marion Groussolles, Norbert Winer, Loïc Sentilhes, Florence Biquart, Mona Massoud, Alexandre J. Vivanti, Hanane Bouchghoul, Patrick Rozenberg, Pascale Olivier, Raoul Desbriere, Celine Chauleur, Franck Perrotin, Frederic Coatleven, Florent Fuchs, Florence Bretelle, Vassilis Tsatsaris, Laurent J. Salomon, Nicolas Sananes, Gilles Kayem, Veronique Houflin-Debarge, Thomas Schmitz, Guillaume Benoist, Catherine Arnaud, Virginie Ehlinger, Christophe Vayssière, Groupe de Recherche en Gynecologie Obstétrique
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?