Effect of Hydration on Spontaneous Labor Outcomes in Nulliparous Pregnant Women: A Multicenter Randomized Controlled Trial Comparing Three Methods

Rodney K. Edwards; Christine A. Reed; Kathryn S. Villano; Jennifer L. Holmes; Suhong Tong; Jill K. Davies

doi:10.1055/s-0033-1351661

American Journal of Perinatology, Table of Contents

Am J Perinatol 2014; 31(06): 455-462
DOI: 10.1055/s-0033-1351661

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of Hydration on Spontaneous Labor Outcomes in Nulliparous Pregnant Women: A Multicenter Randomized Controlled Trial Comparing Three Methods

Rodney K. Edwards

¹Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama, Birmingham School of Medicine, Birmingham, Alabama

,

Christine A. Reed

²Perinatal Clinical Trials Research Center, The Children's Hospital, Aurora, Colorado

,

Kathryn S. Villano

³Regional Obstetric Consultants, Jacksonville, Florida

,

Jennifer L. Holmes

⁴Department of Obstetrics and Gynecology, Intermountain Salt Lake Clinic, Salt Lake City, Utah

,

Suhong Tong

⁵Department of Pediatrics, University of Colorado Denver, Aurora, Colorado

,

Jill K. Davies

⁶Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, Colorado

› Author Affiliations

Abstract

Objective To evaluate the effect of mode and amount of fluid hydration during labor.

Study Design The authors conducted a randomized controlled trial of uncomplicated nulliparous women in spontaneous labor at 36 weeks or more gestational age. Women were randomized to receive lactated Ringer solution with 5% dextrose at (1) 125 mL/h intravenously with limited oral intake, (2) 250 mL/h intravenously with limited oral intake, or (3) 25 mL/h intravenously with ad libitum oral intake of clear liquids. Results were analyzed by intent-to-treat analysis.

Results A total of 311 out of 324 women were available for analysis. Groups 1 (n = 105), 2 (n = 105), and 3 (n = 101) above did not differ significantly for mean labor duration (11.6 ± 5.9, 11.4 ± 5.5, and 11.5 ± 5.9 hours, respectively; p = 0.998), proportion of women in labor > 12 hours (all groups 41%; p = 0.998), proportion receiving oxytocin augmentation (59, 60, and 57%, respectively; p = 0.923), or proportion delivered by cesarean (22, 17, and 17%, respectively; p = 0.309). Indications for cesarean were similar between groups. No cases of pulmonary edema, maternal aspiration, or perinatal mortality occurred.

Conclusion Although apparently safe, neither increased intravenous hydration nor oral hydration during labor improves labor performance.

Keywords

labor - labor dystocia - hydration - oral hydration

Full Text

References

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