DR RPGMC Kangra at Tanda, Set No. 112, Vivekanand Hostel, Kangra, Himachal Pradesh, India.
Arch Gynecol Obstet. 2012 Dec;286(6):1425-30. doi: 10.1007/s00404-012-2485-1. Epub 2012 Aug 4.
The objective of this study was to compare intravenous normal saline with and without 5% dextrose on the course of labor in nulliparous women in active phase of spontaneous labor.
In a randomized controlled trial, term, nulliparous women with singleton pregnancy in active labor were randomized into one of two groups receiving either normal saline or normal saline alternating with 5% dextrose at rate of 175 ml/h. The primary outcome was total length of labor from onset of study fluid in vaginally delivered women. Maternal and neonatal outcomes were also analyzed.
Of 250 women enrolled, in vaginally delivered subjects, there was significant difference in the duration of labor (p=0.0) and prolonged labor (p=0.01), with favorable results for women in 5% dextrose alternating with normal saline. No statistically significant differences were observed in the cesarean section rates between the groups. The cord pH was significantly higher in neonates born to women in 5% dextrose alternating with normal saline infusion as compared to normal saline alone (p=0.01), however, no neonate in the study had acidemia.
Administration of a 5% dextrose solution alternating with normal saline is a better parenteral fluid for significantly decreasing duration of labor in term vaginally delivered nulliparous women in spontaneous active labor as compared to normal saline alone.
本研究旨在比较初产妇自发活跃期分娩时静脉输注生理盐水与含 5%葡萄糖生理盐水对产程的影响。
采用随机对照试验,将足月、初产、单胎妊娠、处于活跃期的孕妇随机分为两组,分别以 175ml/h 的速度输注生理盐水或生理盐水与 5%葡萄糖交替。主要结局是阴道分娩孕妇的总产程。同时分析母婴结局。
在 250 名入组孕妇中,阴道分娩组的产程(p=0.0)和延长产程(p=0.01)有显著差异,5%葡萄糖与生理盐水交替输注的孕妇结果更为有利。两组剖宫产率无统计学差异。与单独输注生理盐水相比,输注 5%葡萄糖与生理盐水交替的孕妇新生儿脐带血 pH 值显著升高(p=0.01),但研究中无新生儿出现酸血症。
与单独输注生理盐水相比,在初产妇自发活跃期分娩时,输注 5%葡萄糖与生理盐水交替的方法是一种更好的静脉补液方法,可以显著缩短产程。