Parenteral Dextrose May Shorten Induced Labor in Nulliparous Women

By Rob Goodier

February 06, 2017

NEW YORK (Reuters Health) - Adding dextrose solution to the IV drip may be a safe, low-cost means of shortening induced labor in nulliparous women, according to new findings.

"Given the fact that muscle performance is improved by glucose replacement during prolonged exercise and that glucose is the main uterus substrate, it appears logical and biologically likely that the gravid uterus in labor improves its efficiency with carbohydrate supplementation," Dr. Josianne Pare of Université de Sherbrooke in Quebec, Canada, told Reuters Health by email.

Dr. Pare and colleagues, who presented their findings on January 26 at the Society for Maternal-Fetal Medicine's conference in Las Vegas, Nevada, enrolled 193 women in their double-blind randomized controlled trial. All participants were pregnant for the first time, all with singletons at full term with head-down presentation, and all had a favorable cervix for induction.

At induction, 96 patients received a 5% dextrose solution in their saline IV drip, while 97 patients were given saline alone. The dextrose treatment continued throughout labor and delivery.

Women who received dextrose were in labor for a median of 423 minutes while the other women had a median labor of 499 minutes (p=0.024). There was no difference in the rate of Cesarean section, APGAR scores or other indicators measured.

"Dextrose 5% with normal saline should be used as the default solute in labor induction among nulliparous women," Dr. Pare said.

While the study suggests a modest benefit with dextrose in the patient population described, there may be an additional point to take into account, according to Dr. John Smulian, chief of maternal-fetal medicine at Lehigh Valley Health Network in Allentown, Pennsylvania, who was not involved in the study.

"This potential benefit should be balanced with the small increased rate of neonatal hypoglycemia observed with the use of dextrose-containing fluids seen in other studies, which was not reported in this abstract," Dr. Smulian told Reuters Health by email. "Nevertheless, use of dextrose-containing solutions is reasonable when used under conditions similar to the study setting."

SOURCE: http://bit.ly/2kWlYDY

Am J Obstet Gynecol 2017.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....