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

Abstract

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 four obstetric residency programs in Pennsylvania. Singleton, term, consenting women presenting in active spontaneous labor with a cervical dilation of <6 cm 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.

• Cesarean delivery
• dextrose
• IV fluids
• labor management

Acknowledgements

The authors are grateful for the administrative support of the following individuals who facilitated the conduct of this study: Sandra Eyer (Associate Project Coordinator Department of Obstetrics and Gynecology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania); Katie Karabasz (Research Assistant, Department of Obstetrics and Gynecology Lehigh Valley Health Network); Carolyn Hoffman (Administrative Assistant The Reading Hospital); Sarah Lopez (Research Assistant, St. Luke’s University Hospital) and Robin Haff (Director, Women’s Health Research, St. Luke’s University Hospital).

Declaration of interest

The authors report no conflict of interest. This project was funded, in part, under a grant with the Pennsylvania Department of Health using Tobacco CURE Funds. The Department specifically disclaims responsibility for any analyses, interpretations or conclusions. This project described also was supported by the National Center for Research Resources, Grant UL1 RR033184 and is now at the National Center for Advancing Translational Sciences, Grant UL1 TR000127. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Clinical Trial Registration: clinicaltrials.gov: NCT01110005.

Notes

†Abstract #89, SMFM 34th Annual Meeting, New Orleans, LA, USA, 3–8 February 2014.