Department of Obstetrics and Gynaecology, Unit 5, Christian Medical College, Ida Scudder Road, Vellore 632 004, India.
Arch Gynecol Obstet. 2012 Feb;285(2):343-6. doi: 10.1007/s00404-011-1978-7. Epub 2011 Jul 12.
To compare the effects of two different regimens of intravenous hydration and oral hydration on the duration of active labor.
Two hundred and ninety-three low risk term primigravida in active labor were randomized into three groups. The first group had 99 patients who received oral fluids only, the second group of 98 patients received intravenous Ringer lactate at the rate of 125 ml/h (IV 125 ml) and the third group had 96 patients who received intravenous Ringer lactate at a rate of 250 ml/h (IV 250 ml). Amniotomy and oxytocin administration were allowed according to the physician's discretion.
The mean duration of labor in the oral fluid group was 391, 363 min in the 125 ml/h group and 343 min in the 250 ml/h group, P = 0.203. The incidence of prolonged labor more than 12 h in the oral fluid group was 7.1% in the oral fluid group, 4.1% in the 125 ml/h group and 3.1% in the 250 ml/h group, P = 0.402. The oxytocin requirement was 37% in the oral group, 32% in the 125 ml/h group and 33% in the 250 ml/h group, P = 0.68. There was a statistically significant reduction in the incidence of vomiting in patients receiving intravenous hydration, i.e. 24.2% in the oral group, 11.2% in the 125 ml/h group and 6.3% in the 250 ml/h group, P = 0.001. There was no difference in the mode of delivery, maternal or neonatal complications between the three groups.
This study establishes a trend towards decreased incidence of prolonged labor and less vomiting in patients receiving intravenous hydration.
比较两种不同静脉补液和口服补液方案对活跃期持续时间的影响。
将 293 例低危足月初产妇随机分为三组。第一组 99 例患者仅接受口服补液,第二组 98 例患者以 125ml/h 的速度接受静脉乳酸林格氏液(IV 125ml),第三组 96 例患者以 250ml/h 的速度接受静脉乳酸林格氏液(IV 250ml)。根据医生的判断允许行人工破膜和催产素治疗。
口服补液组的平均产程时间为 391、363min,125ml/h 组为 343min,250ml/h 组为 343min,P=0.203。口服补液组中 12 小时以上产程延长的发生率为 7.1%,125ml/h 组为 4.1%,250ml/h 组为 3.1%,P=0.402。口服组催产素需求为 37%,125ml/h 组为 32%,250ml/h 组为 33%,P=0.68。接受静脉补液的患者呕吐发生率显著降低,即口服组为 24.2%,125ml/h 组为 11.2%,250ml/h 组为 6.3%,P=0.001。三组间分娩方式、母婴并发症无差异。
本研究表明,接受静脉补液的患者产程延长和呕吐发生率呈下降趋势。