title: Effect of hydration on spontaneous labor outcomes in nulliparous pregnant women: a multicenter randomized controlled trial comparing three methods.
abstract: OBJECTIVE
  To evaluate the effect of mode and amount of fluid hydration during labor.
  
  
  METHODS
  The authors conducted a randomized controlled trial of uncomplicated nulliparous women in spontaneous labor at 36 weeks or more gestational age. Women were randomized to receive lactated Ringer solution with 5% dextrose at (1) 125 mL/h intravenously with limited oral intake, (2) 250 mL/h intravenously with limited oral intake, or (3) 25 mL/h intravenously with ad libitum oral intake of clear liquids. Results were analyzed by intent-to-treat analysis.
  
  
  RESULTS
  A total of 311 out of 324 women were available for analysis. Groups 1 (n = 105), 2 (n = 105), and 3 (n = 101) above did not differ significantly for mean labor duration (11.6 ± 5.9, 11.4 ± 5.5, and 11.5 ± 5.9 hours, respectively; p = 0.998), proportion of women in labor > 12 hours (all groups 41%; p = 0.998), proportion receiving oxytocin augmentation (59, 60, and 57%, respectively; p = 0.923), or proportion delivered by cesarean (22, 17, and 17%, respectively; p = 0.309). Indications for cesarean were similar between groups. No cases of pulmonary edema, maternal aspiration, or perinatal mortality occurred.
  
  
  CONCLUSIONS
  Although apparently safe, neither increased intravenous hydration nor oral hydration during labor improves labor performance.
authors.affiliation: Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama, Birmingham School of Medicine, Birmingham, Alabama.
authors.forename: Rodney K
authors.initials: RK
authors.lastname: Edwards
authors.affiliation: Perinatal Clinical Trials Research Center, The Children's Hospital, Aurora, Colorado.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Reed
authors.affiliation: Regional Obstetric Consultants, Jacksonville, Florida.
authors.forename: Kathryn S
authors.initials: KS
authors.lastname: Villano
authors.affiliation: Department of Obstetrics and Gynecology, Intermountain Salt Lake Clinic, Salt Lake City, Utah.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Holmes
authors.affiliation: Department of Pediatrics, University of Colorado Denver, Aurora, Colorado.
authors.forename: Suhong
authors.initials: S
authors.lastname: Tong
authors.affiliation: Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, Colorado.
authors.forename: Jill K
authors.initials: JK
authors.lastname: Davies
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D002182:Candy; D002585:Cesarean Section; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007053:Ice; D007552:Isotonic Solutions / Q000008:administration & dosage; D007743:Labor, Obstetric / Q000502:physiology; D010120:Oxytocics / Q000008:administration & dosage; D010121:Oxytocin / Q000008:administration & dosage; D010298:Parity; D011247:Pregnancy; D000077331:Ringer's Solution; D013997:Time Factors; D014867:Water / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D007053:Ice; D007552:Isotonic Solutions; D010120:Oxytocics; C011259:gatorade; D014867:Water; D010121:Oxytocin; D000077331:Ringer's Solution; D005947:Glucose