The effects of intravenous hydration regimens in nulliparous women undergoing induction of labor: A systematic review and meta‐analysis

Introduction Labor is both a physiological and physical activity that requires energy expenditure by the woman. Despite this, women are often fasted in labor, with hydration requirements addressed predominantly by intravenous therapy. Little is known about how best to manage this in nulliparous wome...

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Vydáno v:Acta obstetricia et gynecologica Scandinavica Ročník 103; číslo 7; s. 1254 - 1262
Hlavní autoři: Kearney, Lauren, Brady, Susannah, Marsh, Nicole, Davies‐Tuck, Miranda, Nugent, Rachael, Eley, Victoria
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States John Wiley & Sons, Inc 01.07.2024
John Wiley and Sons Inc
Wiley
Témata:
Female
Fluid Therapy - methods
Humans
Hydration
Induced labor
induction of labor
Infusions, Intravenous
Intravenous therapy
Labor, Induced - methods
length of labor
mode of delivery
nullipara
Parity
Pregnancy
Systematic Review
Systematic Reviews
induction of labor
nullipara
length of labor
intravenous therapy
hydration
mode of delivery
ISSN:0001-6349, 1600-0412, 1600-0412
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Shrnutí:Introduction Labor is both a physiological and physical activity that requires energy expenditure by the woman. Despite this, women are often fasted in labor, with hydration requirements addressed predominantly by intravenous therapy. Little is known about how best to manage this in nulliparous women undergoing induction of labor, who can be prone to lengthy labors. Therefore, we undertook a systematic review and meta‐analysis to determine the effects of intravenous hydration regimens on nulliparous women undergoing induction of labor. Material and methods A systematic review and meta‐analysis were conducted. Databases searched were PubMed, CINAHL, Embase, Cochrane, Scopus, and Web of Science using the search strategy combination of associated key concepts for intravenous therapy and nulliparous laboring women. The primary outcome was excessive neonatal weight loss. Meta‐analyses for categorical outcomes included estimates of odds ratio (OR) and their 95% confidence intervals (CI) calculated; and for continuous outcomes the standardized mean difference, each with its 95% CI. Heterogeneity was assessed visually and by using the χ2 statistic and I2 with significance being set at p < 0.10. Results A total of 1512 studies were located and following screening, three studies met the eligibility criteria. No studies reported excessive neonatal weight loss. Increased rates of intravenous therapy (250 mL/h vs. 125 mL/h) during labor were not found to reduce the overall length of labor (mean difference −0.07 h, 95% CI −0.27 to 0.13 h) or reduce cesarean sections (OR 0.74, 95% CI 0.45–1.23), when women were not routinely fasted. Conclusions Our review found no significant improvements for nulliparous women who received higher intravenous fluid volumes when undergoing induction of labor and were not routinely fasted. However, data are limited, and further research is needed. Labor is both a physiological and a physical activity that requires energy expenditure by the woman. Despite this, women are often fasted in labor, with hydration requirements addressed predominantly by intravenous therapy. When nulliparous women undergoing induction of labor are not routinely fasted, higher volumes of intravenous therapy do not shorten labor or reduce the likelihood of cesarean section.
Bibliografie:ObjectType-Article-1
ObjectType-Evidence Based Healthcare-3
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ISSN:0001-6349
1600-0412
1600-0412
DOI:10.1111/aogs.14793