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Oral Concurrent Session 3 Thursday, January 26 • 1:15 PM - 4:00 PM • Augustus V-VI| Volume 216, ISSUE 1, SUPPLEMENT , S23-S24, January 01, 2017

32: Reduction of total labour length through the addition of parenteral dextrose solution in induction of labor in nulliparous: Results of DEXTRONS propective randomized controlled trial

      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 = 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 low-cost and the safety of this intervention, glucose should be used as the default solute during labour.