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

Area of Science:

• Obstetrics and Gynecology
• Intrapartum Fetal Monitoring
• Maternal Health

Background:

• Cesarean delivery is a common obstetric procedure.
• Intrapartum interventions aim to improve maternal and neonatal outcomes.
• The role of intravenous fluid composition in labor management is an area of ongoing research.

Purpose of the Study:

• To investigate whether a 5% glucose-containing intravenous solution administered during labor reduces the likelihood of cesarean delivery.
• To assess the impact of dextrose-containing intravenous fluids on labor characteristics and maternal/neonatal complications.

Main Methods:

• A multi-center, prospective, single-blind, randomized study.
• Involved 309 women in active labor with cervical dilation <6 cm.
• Participants received either lactated Ringer's (LR) or lactated Ringer's with 5% dextrose (D5LR) as maintenance intravenous fluid.

Main Results:

• No statistically significant difference in cesarean delivery rates between the D5LR group (15.0%) and the LR group (11.5%).
• Cesarean birth rate ratio was 1.32 (95% CI, 0.75-2.35; p=0.34).
• No observed differences in labor augmentation rates or intrapartum complications between the groups.

Conclusions:

• Intravenous fluid containing 5% dextrose does not decrease the chance of cesarean delivery for women in active labor.
• The findings suggest that routine use of dextrose-containing IV fluids in this population does not offer a benefit in reducing cesarean births.