ASSESSMENT OF THE EFFECTS OF INCREASED INTRAVENOUS HYDRATION ON THE COURSE OF LABOR IN NULLIPAROUS TERM PREGNANCIES

Physiologists have shown that increased fluids improve skeletal muscle performance in prolonged exercise.Typical orders provide for 125 mL of intravenous fluids per hour in patients taking limited oral fluids during labor. Our purpose in this study was to determine whether increased intravenous fluids affect the progress of labor. In a prospective randomized institutional clinical trial, one-hundred ninety-four nulliparous women with uncomplicated singleton gestations at term in spontaneous active labor with dilatation 2-5 cm and a cephalic presentation were selected. 82 were designed to receive 250 mL per hour of intravenous normal saline in dextrose water (first group), and 112 to receive 125 mL per hour of the same solution (2nd or control group). Prerandomization variables such as mother's age, weight, previous pregnancy history, general health, sex and weight of the newborn, rupture of the membranes and presenting part were balanced between the two groups. The frequency of labor lasting> 10 hours was statistically higher in the 125mL group ([16.7%] vs [7.4%] p< 0.0002). This study showed that increasing fluid administration for nulliparous women in labor is associated with a shorter duration of the first stage and possibly less need for augmentation of uterine contraction ( [4.8% vs 6.25%] p= 0.OO2).Thus dehydration in labor may be a contributing factor for dysfunctional labor and need for cesarean-section, and oxytocin infusion.