一项关于分娩期间两种不同静脉输液的多中心随机试验。
A multi-center randomized trial of two different intravenous fluids during labor.
作者信息
Dapuzzo-Argiriou Lisa M, Smulian John C, Rochon Meredith L, Galdi Luisa, Kissling Jessika M, Schnatz Peter F, Gonzalez Rios Angel, Airoldi James, Carrillo Mary Anne, Maines Jaimie, Kunselman Allen R, Repke John, Legro Richard S
机构信息
a Department of Obstetrics and Gynecology , Lehigh Valley Health Network , Allentown , PA , USA .
b University of South Florida Morsani College of Medicine , Tampa , FL , USA .
出版信息
J Matern Fetal Neonatal Med. 2016;29(2):191-6. doi: 10.3109/14767058.2014.998190. Epub 2015 Sep 4.
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.
目的
确定在分娩期使用含5%葡萄糖的静脉输液是否会降低活跃期分娩妇女剖宫产的几率。
方法
这是一项在宾夕法尼亚州四个产科住院医师培训项目中实施的多中心、前瞻性、单（患者）盲法、随机研究设计。单胎、足月、自愿参与的活跃自发宫缩且宫颈扩张<6 cm的妇女被随机分为接受含或不含5%葡萄糖的乳酸林格氏液（LR对比D5LR）作为维持静脉输液。主要结局是剖宫产率。次要结局包括产程特征以及孕产妇或新生儿并发症。
结果
共分析了309名妇女。各研究组间人口统计学变量和入院时宫颈扩张情况相似。D5LR组的剖宫产率（23/153或15.0%）与LR组（18/156或11.5%）相比无显著差异，[相对危险度（95%可信区间）为1.32（0.75，2.35），p = 0.34]。在引产率或分娩期并发症方面无差异。
结论
对于活跃期入院的妇女，使用含5%葡萄糖的静脉输液不会降低剖宫产的几率。
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