Glucose supplementation significantly reduces the length of the first and second stages of labour without increasing the rate of complication in induced, nulliparous women, found a study presented at the Society for Maternal-Foetal Medicine’s annual meeting.
Researchers with the Université de Sherbrooke in Sherbrooke, Quebec, Canada, in a study presented at the Society for Maternal-Foetal Medicine’s annual meeting, The Pregnancy Meeting, investigated the use of glucose to shorten induced labour in nulliparous (first time giving birth). The primary outcome studied was the total length of active labour.
Prolonged labour can be harmful to maternal and foetal health. Few medical interventions are known to shorten labour duration. Because muscle performance is known to be improved by glucose supplementation, the researchers tested whether adding glucose to the intravenous hydration solution women receive during labour could accelerate labour.
Two hundred pregnant women were randomly assigned to receive either a standard hydration solution containing salt and water or a solution containing glucose, salt and water.
Dr Josianne Paré, with the department of obstetrics & gynaecology at the University of Sherbrooke and the presenter of the research at the SMFM annual meeting, explained, “We found that the median duration of labour was 76 minutes shorter in the group of women receiving glucose. There was no difference in the mode of delivery (caesarean section, forceps), or the neonatal well-being measures.” Paré continued, “Glucose supplementation therefore significantly reduces the total length of labour without increasing the rate of complication. This is great news for women experiencing induced labour.”
The researchers concluded that, given the low-cost and safety of this intervention, glucose should be the solute of choice during labour.
Abstract
Objective: Prolonged labour is a significant cause of maternal et foetal morbidity. Optimal uterine muscle function is critical to efficient active second stage of labour. The physiology of squelettal muscle suggests that glucose supplementation might improve muscle performance. The goal of our study was to provide reliable evidence as to whether IV glucose supplementation during labour induction in nulliparous women can reduce total duration of active labour.
Study Design: We performed a prospective triple-blinded randomized-controlled trial investigating the use of parental IV of dextrose 5% with normal saline versus normal saline in 190 induced nulliparous women. Inclusion criteria were monofoetal pregnancy at term with cephalic presentation and favourable cervix. After informed consent, patients were randomly assigned to receive either 250 mL/hour of IV dextrose 5% with normal saline or 250 mL/hour of normal saline for the whole duration of induction, labour and delivery. The primary outcome studied was the total length of active labour. Secondary outcomes include duration of second active stage of labour, mode of delivery and newborn APGAR score.
Results: The duration of first and second stage of labour were significantly reduced in the dextrose group (441 versus 505 minutes, p ¼ 0.045). The proportion of patients delivered at 200 minutes was 19% in the dextrose group versus 8% in the normal saline group. The proportion of patients delivered at 450 minutes was 75% in the dextrose group versus 61% in the normal saline group. There were no difference in the rate of cesarean section and APGAR score.
Conclusion: Glucose supplementation significantly reduces the length of the first and second stages of labour without increasing the rate of complication in induced, nulliparous women. Given the lowcost and the safety of this intervention, glucose should be used as the default solute during labour. 33 Randomized control trial of IV acetaminophen.
Authors
Josianne Paré , Jean-Charles Pasquier, Antoine Lewin, William Fraser, Yves-André
[link url="https://www.sciencedaily.com/releases/2017/01/170123094719.htm"]Society for Maternal-Foetal Medicine material[/link]
[link url="http://www.smfmnewsroom.org/"]The Pregnancy Meeting abstract[/link]