A randomized, double-blinded, controlled trial comparing parenteral normal saline with and without dextrose on the course of labor in nulliparas

Shrivastava, Vineet; Garite, Thomas J.; Jenkins, Sheri M.; Saul, Lisa; Rumney, Pamela; Preslicka, Christine; Chan, Kenneth

doi:10.1016/j.ajog.2008.11.030

Cited by 31 publications

(19 citation statements)

References 12 publications

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“…Fisher and Huddleston 14 demonstrated that adding 5% glucose to intrapartum IV fluid of lactated Ringer's solution reduces umbilical cord acidemia and hypercarbia without changing the cord levels of glucose or base excess. Sharma, et al 6 also found slightly higher umbilical artery pH values with a 5% dextrose solution. As with our study, several smaller studies were unable to confirm these findings.…”

Section: Discussionmentioning

confidence: 91%

“…Both of these trials were confined to nulliparous women. Sharma, et al 6 randomized 250 women to either normal saline (NS) or NS alternated with NS plus 5% dextrose at 175 ml per hour. They found no difference in the cesarean rate between groups, although labor was shorter with fewer prolonged labors in women delivering vaginally.…”

Section: Discussionmentioning

confidence: 99%

“…There are 2 studies suggesting a shorter duration of labor in nulliparous women when glucose was added to the intrapartum IV fluids, although neither study demonstrated a reduction in the cesarean delivery rate. 6,7 …”

Section: Introductionmentioning

confidence: 99%

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A multi-center randomized trial of two different intravenous fluids during labor

Dapuzzo-Argiriou

Smulian

Rochon

et al. 2015

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective To determine if the intrapartum use of a 5% glucose-containing intravenous solution decreases the chance of a cesarean delivery for women presenting in active labor. Methods This was a multi-center, prospective, single (patient) blind, randomized study design implemented at 4 obstetric residency programs in Pennsylvania. Singleton, term, consenting women presenting in active spontaneous labor with a cervical dilation of <6cm were randomized to lactated Ringer's with or without 5% glucose (LR versus D5LR) as their maintenance intravenous fluid. The primary outcome was the cesarean birth rate. Secondary outcomes included labor characteristics, as well as maternal or neonatal complications. Results There were 309 women analyzed. Demographic variables and admitting cervical dilation were similar among study groups. There was no significant difference in the cesarean delivery rate for the D5LR group (23/153 or 15.0%) versus the LR arm (18/156 or 11.5%), [RR (95%CI) of 1.32 (0.75, 2.35), P=0.34]. There were no differences in augmentation rates or intrapartum complications. Conclusions The use of intravenous fluid containing 5% dextrose does not lower the chance of cesarean delivery for women admitted in active labor.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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A multi-center randomized trial of two different intravenous fluids during labor

Dapuzzo-Argiriou

Smulian

Rochon

et al. 2015

The Journal of Maternal-Fetal & Neonatal Medicine

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“…The incidence of labor lasting >12 hours was decreased from 22% to about 10% (37). Five percent dextrose has also been associated with less umbilical cord acidemia compared to lactated Ringer's solution (38).…”

Section: Fluids (Or Not) Ratementioning

confidence: 97%

Before labor and first stage of labor

Berghella¹

2012

Obstetric Evidence Based Guidelines

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“…A recent randomized study of intravenous glucose, which did show a shortening of the duration of labor in patients receiving glucose versus saline alone, did not show any deleterious effects of glucose in the newborn, including specifically no change in bilirubin, blood glucose, or pH at birth. 12 However, this is fluid maintenance and not boluses and there may be differences. One theoretical issue important to this discussion is the effect of the presence of increased glucose in fetuses that may be hypoxemic as the presence of increased amounts of this substrate could produce increase amounts of lactate in the process or anaerobic metabolism, thus decreasing pH further and increasing the likelihood of damage.…”

Section: Increasing Intravenous Hydrationmentioning

confidence: 99%

Intrauterine Resuscitation During Labor

Garite

Simpson

2011

Clinical Obstetrics &Amp; Gynecology

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Intrauterine resuscitative measures are commonly initiated during labor when the fetal heart rate (FHR) pattern is indeterminate or abnormal. The most effective use of these measures is directed at the presumed underlying cause. However, some FHR patterns are nonspecific, while others are such that intrauterine resuscitation will not remedy the situation. The goals of intrauterine resuscitation during labor are, at its best, to reverse any hypoxia that might lead to further deterioration, and at the very least to avoid prolonged periods of indeterminate or abnormal FHR patterns, which may cause unnecessary concern for caregivers and patients and unnecessary operative intervention.

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A randomized, double-blinded, controlled trial comparing parenteral normal saline with and without dextrose on the course of labor in nulliparas

Cited by 31 publications

References 12 publications

A multi-center randomized trial of two different intravenous fluids during labor

A multi-center randomized trial of two different intravenous fluids during labor

Before labor and first stage of labor

Intrauterine Resuscitation During Labor

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