Intravenous fluids for reducing the duration of labour in low risk nulliparous women

Dawood, Feroza; Dowswell, Therese; Quenby, Siobhán

doi:10.1002/14651858.cd007715.pub2

Cited by 44 publications

(50 citation statements)

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“…Such routine use should be avoided, as it increases the difficulty for women’s mobility in labour and because of the related side effects, such as uterine tachysystole, hypertonic uterine dysfunction, uterine rupture and acute fetal distress [28–30]. Similarly, episiotomy and placement of a venous catheter for hydration as routine support have not been proved beneficial for women [31–33]. Even though a woman’s birthing position should be her choice and respected by the care team [34], the majority of women gave birth in lithotomy position, most times with someone performing Kristeller maneuver; such practices can cause discomfort, pain, and pose risks for women, their newborn and have subsequently been banned in many countries [35].…”

Section: Discussionmentioning

confidence: 99%

Labor and birth care by nurse with midwifery skills in Brazil

Gama

Viellas

Torres³

et al. 2016

Reprod Health

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BackgroundThe participation of nurses and midwives in vaginal birth care is limited in Brazil, and there are no national data regarding their involvement. The goal was to describe the participation of nurses and nurse-midwives in childbirth care in Brazil in the years 2011 and 2012, and to analyze the association between hospitals with nurses and nurse-midwives in labor and birth care and the use of good practices, and their influence in the reduction of unnecessary interventions, including cesarean sections.MethodsBirth in Brazil is a national, population-based study consisting of 23,894 postpartum women, carried out in the period between February 2011 and October 2012, in 266 healthcare settings. The study included all vaginal births involving physicians or nurses/nurse-midwives. A logistic regression model was used to examine the association between the implementation of good practices and suitable interventions during labor and birth, and whether care was a physician or a nurse/nurse-midwife led care. We developed another model to assess the association between the use of obstetric interventions during labor and birth to the personnel responsible for the care of the patient, comparing hospitals with decisions revolving exclusively around a physician to those that also included nurses/nurse-midwives as responsible for vaginal births.Results16.2 % of vaginal births were assisted by a nurse/nurse-midwife. Good practices were significantly more frequent in those births assisted by nurses/nurse-midwives (ad lib. diet, mobility during labor, non-pharmacological means of pain relief, and use of a partograph), while some interventions were less frequently used (anesthesia, lithotomy position, uterine fundal pressure and episiotomy). In maternity wards that included a nurse/nurse-midwife in labour and birth care, the incidence of cesarean section was lower.ConclusionsThe results of this study illustrate the potential benefit of collaborative work between physicians and nurses/nurse-midwives in labor and birth care. The adoption of good practices in managing labor and birth could be the first step toward more effective obstetric and midwifery care in Brazil. It may be easier to introduce new approaches rather than to eliminate old ones, which may explain why the reduction of unnecessary interventions during labor and birth was less pronounced than the adoption of new practices.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-016-0236-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Labor and birth care by nurse with midwifery skills in Brazil

Gama

Viellas

Torres³

et al. 2016

Reprod Health

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“…Yet despite the evidence, the American Society of Anesthesia (2007) and the American College of Obstetricians and Gynecologists (ACOG; 2009a) continue to recommend that oral intake for low-risk women be restricted to clear fluids. Dawood, Dowswell, and Quenby (2013) conducted a Cochrane review of the effect of intravenous fluids on length of labor. They note as background that there is almost no risk of aspiration when general anesthesia is administered today, and because there is no clear evidence of harm associated with oral intake during labor, the practice should be abandoned and rather than routine administration of intravenous fluids, they should only be administered for clinical reasons or if the women become ketotic.…”

Section: Electronic Fetal Monitoringmentioning

confidence: 99%

Healthy Birth Practice #4: Avoid Interventions Unless They Are Medically Necessary

Lothian¹

2014

J Perinat Educ

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Maternity care in the United States is intervention intensive. The routine use of intravenous fluids, restrictions on eating and drinking, continuous electronic fetal monitoring, epidural analgesia, and augmentation of labor characterize most U.S. births. The use of episiotomy is far from restrictive. These interventions disturb the normal physiology of labor and birth and restrict women's ability to cope with labor. The result is a cascade of interventions that increase risk, including the risk of cesarean surgery, for women and babies. Seventeen percent of women had an episiotomy, and 31% had a cesarean. The high use of these interventions reflects a system-wide maternity care philosophy of expecting trouble. There is an increasing body of research that suggests that the routine use of each of these interventions, rather than decreasing the risk of trouble in labor and birth, actually increases complications for both women and their babies.The purpose of this article is to review the literature related to the evidence base and the outcomes associated with the interventions routinely used in labor and birth in the United States. The findings make the case for the value of maternity care that avoids the use of routine interventions.Maternity care in the United States is intervention intensive. Listening to Mothers III (Declercq, Sakala, Corry, Applebaum, & Herrlich, 2013), the most recent national survey of women's pregnancy, birth, and postpartum experiences, reports that for women who gave birth from June 2011 to June 2012, 89% of women experienced electronic fetal monitoring (66% continuously), 62% received intravenous fluids, 79% experienced restrictions on eating, and 60% experienced restrictions on drinking in labor. Sixty-seven percent of women who gave birth vaginally had an epidural in labor, and 31% were given Pitocin to speed up their labors. Twenty percent of women had their membranes artificially ruptured.

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“…A Cochrane database meta-analysis searched for studies about the administration of an intravenous infusion to reduce the duration of labor in nulliparas (19 studies, n=3130) [62]. It did not study the effect of this practice on oxytocin use during labor.…”

Section: Intravenous Infusion During Labormentioning

confidence: 99%

Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Chapter 3: Interventions associated with oxytocin administration during spontaneous labor

Barasinski

Vendittelli

2017

Journal of Gynecology Obstetrics and Human Reproduction

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A c c e p t e d M a n u s c r i p t 2 2 SummaryObjectives. ─ The objective of our work was to determine the effects of co-interventions used during labor with oxytocin or for labor dystocia.Methods. ─ We searched for reports of the interventions we sought to study published between 1987 and 2015, looking especially for meta-analyses and randomized trials via the Medline database and the Cochrane Library. We limited our research to studies of spontaneous labor in singleton pregnancies at term. Conclusions. ─ Few of the co-interventions studied appear to modulate recourse to oxytocin.

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Intravenous fluids for reducing the duration of labour in low risk nulliparous women

Cited by 44 publications

References 44 publications

Labor and birth care by nurse with midwifery skills in Brazil

Labor and birth care by nurse with midwifery skills in Brazil

Healthy Birth Practice #4: Avoid Interventions Unless They Are Medically Necessary

Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Chapter 3: Interventions associated with oxytocin administration during spontaneous labor

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