The Effects of Intravenous Dextrose 5%, Ringer’s Solution and Oral Intake on the Duration of Labor Stages in Nulliparous Women: A Double-blind, Randomized, Controlled Trial

Abstract

Abstract: Objective: Child-birth consists of a three-stage period beginning with uterine contractions and ending in the expulsion of the placenta. Ineffective uterine contractions along with pelvic restraint are among the most common reasons for the poor progress and prolonged stages of labor and dystocia. Several factors that affect the stages of labor. One of the subjects that has received less attention in research is the effect of liquids on labor. The present study was conducted to compare the effects of Ringer's solution, dextrose solution 5% and oral intake on the duration of labor stages in nulliparous women with spontaneous vaginal delivery. Methods: This double-blind (i.e. blinded researcher and participants), randomized, controlled trial was conducted on 201 nulliparous women in labor with low-risk pregnancies presenting to the maternity ward of Imam Khomeini Hospital of Mahabad, Iran, from March to October 2016. participants assigned with a randomized block design to three groups, each receiving either Ringer’s solution plus oral fluids, dextrose 5% solution plus oral fluids or oral fluids alone. The solutions were intravenously administered at a rate of 125 ml/h in the groups receiving the solutions and the subjects in the oral fluids group could consume liquids of their choice (water, orange juice and apple juice). The duration of labor stages in minutes and maternal outcomes from start of the intervention was evaluated 2 hours after delivery. The primary outcome in this study was the duration of labor stages (the first, second and third stages of labor) in nulliparous women with vaginal delivery. Data were collected using a demographic information form, an examination checklist and a partograph. Analyze data using descriptive statistics such as frequency tables and central and dispersion parameters and analytical statistics included ANOVA, Kruskal-Wallis and chi-square test was conducted with 21 SPSS software. The level of statistical significance was set at 0.05 for all the tests. Results: The mean (SD) duration of the active phase of labor in dextrose 5% was shorter than the other two groups and statistically significant difference was observed between groups (P<0.001). A significant difference was also observed between the three groups in terms of the duration of the third stage of labor (P<0.001); however, no significant differences were observed in terms of the duration of the second stage of labor (P=0.058). Furthermore, a significant difference was observed between the three groups in terms of the Type of delivery (P=0.003), need for oxytocin administration (P<0.001), the frequency of prolonged labor (P=0.001) and the first minute Apgar score (P=0.003). Conclusion: The results suggest that the consumption of dextrose solution by nulliparous women reduces the duration of labor compared to when Ringer’s solution and oral fluids are used. And compar Ringer and oral fluids during labor is more favorable and can be safely be used during labor.