In a study to be presented Thursday, Jan. 26, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting™, researchers with the Université de Sherbrooke in Sherbrooke, Quebec, Canada will present their findings in a study titled, Reduction of total labor length through the addition of parenteral dextrose solution in induction of labor in nulliparous: results of DEXTRONS prospective randomized controlled trial. The study investigated the use of glucose to shorten induced labor in nulliparous (first time giving birth). The primary outcome studied was the total length of active labor.
Prolonged labor can be harmful to maternal and fetal health. Few medical interventions are known to shorten labor duration. Because muscle performance is known to be improved by glucose supplementation, the researchers tested whether adding glucose to the intravenous hydration solution women receive during labor could accelerate labor. Two hundred pregnant women were randomly assigned to receive either a standard hydration solution containing salt and water or a solution containing glucose, salt and water.
Josianne Pare, M.D., with the Department of Obstetrics & Gynecology at the University of Sherbrooke and the presenter of the research at the SMFM annual meeting, explained, "We found that the median duration of labor was 76 minutes shorter in the group of women receiving glucose. There was no difference in the mode of delivery (cesarean section, forceps, etc.), or the neonatal well-being measures." Pare continued, "Glucose supplementation therefore significantly reduces the total length of labor without increasing the rate of complication. This is great news for women experiencing induced labor."
The researchers concluded that, given the low-cost and safety of this intervention, glucose should be the solute of choice during labor.
About the Society for Maternal-Fetal Medicine
The Society for Maternal-Fetal Medicine (est. 1977) is the premiere membership organization for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine. The society is devoted to reducing high-risk pregnancy complications by sharing expertise through continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual meeting in which groundbreaking new ideas and research in the area of maternal-fetal medicine are shared and discussed. For more information visit http://www.smfm.org.
Abstract #32 Reduction of total labor length through the addition of parenteral dextrose solution in induction of labor in nulliparous: Results of DEXTRONS propective randomized controlled trial
Josianne Pare´, Jean-Charles Pasquier, Antoine Lewin, William Fraser, Yves-Andre´ Bureau Université de Sherbrooke, Sherbrooke, QC, Canada
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 ¼ 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 lowcost and the safety of this intervention, glucose should be used as the default solute during labour. 33 Randomized control trial of IV acetaminophen