Ahadi Yulghunlu Fatemeh, Sehhatie Shafaie Fahimeh, Mirghafourvand Mojgan, Mohaddesi Hamideh
Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
J Matern Fetal Neonatal Med. 2020 Jan;33(2):289-296. doi: 10.1080/14767058.2018.1489792. Epub 2018 Sep 9.
Childbirth consists of a three-stage period beginning with uterine contractions and ending in the expulsion of the placenta. The present study was conducted to compare the effects of Ringer's solution, dextrose solution 5%, and oral intake on the duration of total labor and labor stages (primary outcome) and the frequency of oxytocin administration and prolonged labor (secondary outcome) in nulliparous women with spontaneous vaginal delivery. The present randomized clinical trial was conducted on 201 nulliparous women in labor assigned with a randomized block design to three groups, each receiving either Ringer's solution plus oral fluids, dextrose solution 5% solution plus oral fluids or oral fluids alone. The solutions were intravenously administered at a rate of 125 ml/h in the groups receiving the solutions and the subjects in the oral fluids group could consume liquids of their choice (water, orange juice, and apple juice). The duration of total labor and labor stages (the active stage, the second, and third stages of labor) were recorded by the researcher in minutes. Furthermore, the frequency of oxytocin administration and prolonged labor were recorded by the researcher by using a checklist. Data were analyzed using the Kruskal-Wallis test, Mann-Whitney's -test, chi- square test and Fisher exact test. The mean (±SD) duration of total labor was 301.2 (±50.0) minutes in the Ringer group, 171.9 (±36.4) in the dextrose 5% group, and 524.8 (±103.4) in the oral fluids group, suggesting a statistically significant intergroup difference ( < .001). The mean (±SD) duration of the active stage of labor was 276.7 (±91.3) minutes in the Ringer group, 150.6 (±78.5) in the dextrose 5% group, and 302.4 (±136.8) in the oral fluids group, suggesting a statistically significant intergroup difference ( < .001). A significant difference was also observed between the three groups in terms of the duration of the third stage of labor ( < .001); however, no significant differences were observed in terms of the duration of the second stage of labor ( = .058). Furthermore, a significant difference was observed between the three groups in terms of the need for oxytocin administration ( ≤ .001) and the frequency of prolonged labor ( = .001). The results suggest that the consumption of dextrose solution by nulliparous women reduces the duration of labor, the need for oxytocin administration and the frequency of prolonged labor compared to when Ringer's solution and oral fluids are used.
分娩包括一个三个阶段的时期,始于子宫收缩,终于胎盘排出。本研究旨在比较林格氏液、5%葡萄糖溶液和口服摄入对初产妇自然阴道分娩的总产程和产程阶段时长(主要结局)以及催产素使用频率和产程延长情况(次要结局)的影响。本随机临床试验对201名分娩中的初产妇进行,采用随机区组设计分为三组,每组分别接受林格氏液加口服补液、5%葡萄糖溶液加口服补液或仅口服补液。在接受溶液的组中,溶液以125毫升/小时的速度静脉输注,口服补液组的受试者可饮用其选择的液体(水、橙汁和苹果汁)。研究人员记录总产程和产程阶段(活跃期、第二产程和第三产程)的时长,以分钟为单位。此外,研究人员使用检查表记录催产素的使用频率和产程延长情况。数据采用Kruskal-Wallis检验、Mann-Whitney检验、卡方检验和Fisher精确检验进行分析。林格氏液组总产程的平均(±标准差)时长为301.2(±50.0)分钟,5%葡萄糖溶液组为171.9(±36.4)分钟,口服补液组为524.8(±103.4)分钟,提示组间差异具有统计学意义(<0.001)。林格氏液组活跃期产程的平均(±标准差)时长为276.7(±91.3)分钟,5%葡萄糖溶液组为150.6(±78.5)分钟,口服补液组为302.4(±136.8)分钟,提示组间差异具有统计学意义(<0.001)。三组在第三产程时长方面也观察到显著差异(<0.001);然而,在第二产程时长方面未观察到显著差异(=0.058)。此外,三组在催产素使用需求(≤0.001)和产程延长频率(=0.001)方面观察到显著差异。结果表明,与使用林格氏液和口服补液相比,初产妇饮用葡萄糖溶液可缩短产程时长、减少催产素使用需求和产程延长频率。