School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia.
Women's and Newborn Services, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Queensland, Australia.
Birth. 2024 Jun;51(2):253-263. doi: 10.1111/birt.12773. Epub 2023 Oct 6.
Inconsistent practice relating to intrapartum hydration assessment and management is reported, and potential harm exists for laboring women and birthing persons.
Labor and birth are physically demanding, and adequate nutrition and hydration are essential for labor progress. A lack of clear consensus on intrapartum hydration assessment and management during labor and birth currently exists. In addition, there is an inconsistent approach to managing hydration, often including a mixture of intravenous and oral fluids that are poorly monitored.
The aim of this scoping review was to identify and collate evidence-based guidelines for intrapartum hydration assessment and management of maternal hydration during labor and birth.
PubMed, Embase, and CINAHL databases were searched, in addition to professional college association websites. Inclusion criteria were intrapartum clinical guidelines in English, published in the last 10 years.
Despite searching all appropriate databases in maternity care, we were unable to identify evidence-based guidelines specific to hydration assessment and management, therefore resulting in an "empty review." A subsequent review of general intrapartum care guidelines was undertaken. Our adapted review identified 12 guidelines, seven of which referenced the assessment and management of maternal hydration during labor and birth. Three guidelines recommend that "low-risk" women in spontaneous labor at term should hold determination over what they ingest in labor. No recommendations with respect to assessment and management of hydration for women undergoing induction of labor were found.
Despite the increasing use of intravenous fluid as an adjunct to oral intake to maintain maternal intrapartum hydration, there is limited evidence and, subsequently, guidelines to determine best practice in this area. How hydration is assessed was also largely absent from general intrapartum care guidelines, further perpetuating potential clinical variation in this area.
There is an absence of guidelines specific to the assessment and management of maternal hydration during labor and birth, despite its importance in ensuring labor progress and safe care.
据报道，产时水分评估和管理的实践不一致，这对产妇和分娩者存在潜在危害。
分娩是一项体力要求很高的过程，充足的营养和水分对于分娩进展至关重要。目前，在分娩期间对产妇水分评估和管理缺乏明确的共识。此外，管理水分的方法也不一致，通常包括静脉和口服补液的混合，而且这些补液的监测很差。
本范围综述的目的是确定和整理关于产时水分评估和管理以及分娩期间产妇水分管理的循证指南。
检索了 PubMed、Embase 和 CINAHL 数据库，以及专业学院协会网站。纳入标准为英文的产时临床指南，发表时间在过去 10 年。
尽管在产妇护理的所有适当数据库中进行了搜索，但我们无法确定特定于水分评估和管理的循证指南，因此导致了“空综述”。随后对一般产时护理指南进行了审查。我们改编的综述确定了 12 项指南，其中 7 项指南提到了分娩期间产妇水分的评估和管理。有 3 项指南建议在足月自然分娩的“低风险”妇女应该自主决定在分娩期间摄入什么。没有发现关于引产妇女水分评估和管理的建议。
尽管静脉补液作为口服摄入的辅助手段来维持产妇产时水分，但在这方面的最佳实践仍然缺乏证据，因此指南也有限。水分的评估也在很大程度上缺乏一般产时护理指南，这进一步加剧了这方面的潜在临床差异。
尽管分娩期间产妇水分评估和管理对确保分娩进展和安全护理非常重要，但缺乏具体的指南。
