March 20, 2017
Hospitals can reduce the number of cesarean sections they perform and shorten the length of labor among pregnant women by giving more intravenous fluid than is typically administered in the United States, researchers at Thomas Jefferson University Hospital say.
In a study published online last week, obstetrics and gynecology researchers at Jefferson analyzed data from several conflicting studies on the physiological function of laboring women at different levels of hydration.
Given the demands placed on the uterine muscle, pelvis and birth canal during labor, even low levels of dehydration can compromise a woman's ability to give birth vaginally.
Dr. Vincenzo Berghella, director of Maternal Fetal Medicine at the Sydney Kimmel Medical College, was joined by colleagues in a review of seven small clinical trials involving a total of 1,215 women. About half of the women (593) were administered IV fluids at a rate of 250 milliliters per hour, while the other half (622) received IV fluids at the general practice rate of 125 milliliters per hour.
When the research team pooled the data, they found that women at the higher fluid rate were not only less likely to get a c-section, but also had reduced periods of labor by an average of 64 minutes. The pushing phase among these women was also shortened by an average of three minutes.
“The results are compelling and strongly argue for a change in practice,” Berghella said. “We have already begun changing practice at Jefferson to give women more fluids in labor, to allow them to have the best chance of delivering vaginally.”
About one in three births in the United States occurs through a c-section even as obstetricians seek ways to safely bring this number down.
“We’ve known that it’s important for women to stay well-hydrated during pregnancy and labor," Berghella continued. "This study suggests that IV fluids could help women maintain hydration at appropriate levels, reduce the likelihood of c-section, and decrease length of labor."