بررسی موارد نیاز به استفاده از کاتتر وریدی در جریان زایمان طبیعی

Background and purpose: Although the necessity of NPO condition during normal labour is a controversial subject among obstetricians and anesthesiologists, the most valid midwifery references emphasize on necessity of vein catheter use in all cases during normal labour. Now a days, most hospitals routinely use vein catheter even in cases with no indication and this may lead to decrease of motility and comfort of parturient, increase in cost and probability of blood transmitted pathogens. According to the policy of the ministry of health on decreasing venous injection, this study carried out to assess the real necessity of vein catheter and describing various drugs during labour. Materials and Methods: This is a descriptive-analytical study carried out in Niknafs hospital of Rafsanjan. 380 pregnant women hospitalized for normal delivery and actually delivered normally were selected. Proper questinaires were filled in labour unit and the data analyzed using SPSS software. Results: The mean age, gravidity and parity were 25.9 , 2.3 and 1.1 respectively. In average, the patients had 5.1cm cervix dilatation when they were admitted and after that they stayed in labour unit until delivery which took an average time of 3 hours and 34.3 minuites. The mean time between admission and start of vein catheter use was just 33.3 minuits. The mean volume of infused fluid during labour via vein catheter was 365 ml. According to valid midwifery texts, there was no indication for vein catheter use in 87.3% of subjects. Only 21.7% of the subjects did not get syntocinon via vein catheter whereas 36% with physician order and 42.3% without physician order received syntocinon. Except for that, only 6.7% of the patients got other drugs. The type of fluid in 76.3% of the cases was ringer lactate solution. In average they received 115.72 ml fluid per hour. Conclusion: Regarding the small average amount of received fluid (mostely ringer lactate solution), it can be concluded that vein catheter does not have that much effect on preventing hypoglycemia and dehydration, it is not useful very much for prescribing other drugs and it provides a ready way for useless and wide syntocinon use that can lead to various side effects like neonatal hyper bilirobinemia. Therefor, it is essential to restrict the use of vein catheter to cases with real indication and appropriate time.