Puder K S, Sorokin Y, Bottoms S F, Hallak M, Cotton D B
Division of Maternal-Fetal Medicine, Hutzel Hospital, Wayne State University, Detroit, Michigan.
Obstet Gynecol. 1994 Dec;84(6):956-9.
To determine whether various solutions commonly used in amnioinfusion during labor affect neonatal electrolyte and blood gas values.
Amnioinfusion for thick meconium or severe variable fetal heart rate decelerations is used at our institution according to a standardized protocol. During alternating 3-week periods, the only solution made available for amnioinfusion was either normal saline or Ringer's lactate. Bolus volume, rate, and duration of infusion were determined by the individual physicians. At delivery, cord blood was collected for electrolyte and blood gas determination. These values were compared between the two solution groups and to a non-infused control group.
Complete data on neonatal electrolytes and blood gas values were available on 53 infusion patients (20 Ringer's lactate, 33 normal saline) and 39 non-infusion patients. Comparing infusion to non-infusion patients and those infused with Ringer's lactate to those with normal saline, we found no significant difference in demographics, neonatal outcome variables, duration of labor, neonatal electrolytes, and cord blood gas values. Infusion variables (bolus volume, infusion rate, hours infused, and total volume infused) did not differ between solutions. Total volume and hours of infusion were closely correlated with each other (r = 0.93, P < .001); both were correlated with neonatal chloride (r = 0.38 and r = 0.36, respectively; P < .005). No cases of hypernatremia or hyperchloremia were found in any of the groups. The type of solution used had no effect on the neonatal chloride trend.
The use of both normal saline and Ringer's lactate for indicated amnioinfusion in labor appears to have no clinically significant effect on neonatal electrolytes.
确定分娩期羊膜腔灌注常用的各种溶液是否会影响新生儿电解质和血气值。
在我们机构，根据标准化方案对浓稠胎粪或严重变异型胎儿心率减速进行羊膜腔灌注。在交替的3周期间，羊膜腔灌注仅可使用生理盐水或乳酸林格氏液。推注量、速率和输注持续时间由个体医生确定。分娩时，采集脐带血进行电解质和血气测定。比较两组溶液组以及未输注的对照组之间的这些值。
有53例输注患者（20例使用乳酸林格氏液，33例使用生理盐水）和39例未输注患者的新生儿电解质和血气值完整数据。比较输注患者与未输注患者，以及输注乳酸林格氏液的患者与输注生理盐水的患者，我们发现人口统计学、新生儿结局变量、产程、新生儿电解质和脐带血气值方面无显著差异。两种溶液的输注变量（推注量、输注速率、输注小时数和输注总量）无差异。输注总量和输注小时数彼此密切相关（r = 0.93，P <.001）；两者均与新生儿氯化物相关（分别为r = 0.38和r = 0.36；P <.005）。所有组均未发现高钠血症或高氯血症病例。所用溶液类型对新生儿氯化物趋势无影响。
分娩期对有指征的羊膜腔灌注使用生理盐水和乳酸林格氏液似乎对新生儿电解质无临床显著影响。
