Effect of hydration on spontaneous labor outcomes in nulliparous pregnant women: a multicenter randomized controlled trial comparing three methods

Am J Perinatol. 2014 Jun;31(6):455-62. doi: 10.1055/s-0033-1351661. Epub 2013 Jul 24.

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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Intravenous
  • Administration, Oral
  • Adolescent
  • Adult
  • Candy
  • Cesarean Section
  • Female
  • Fluid Therapy / methods*
  • Glucose / administration & dosage
  • Humans
  • Ice
  • Isotonic Solutions / administration & dosage
  • Labor, Obstetric* / physiology
  • Oxytocics / administration & dosage
  • Oxytocin / administration & dosage
  • Parity
  • Pregnancy
  • Ringer's Solution
  • Time Factors
  • Water / administration & dosage
  • Young Adult

Substances

  • Ice
  • Isotonic Solutions
  • Oxytocics
  • gatorade
  • Water
  • Oxytocin
  • Ringer's Solution
  • Glucose