Women Undergoing Goal-Directed Fluid Therapy During Pregnancy: A Systematic Review and Meta-Analysis of Published Randomized Controlled Trials

Abstract

Introduction: Goal-directed fluid therapy "GDFT" is a method of oxygen delivery and hemodynamics optimization using vasoactive and fluid infusions. According to several studies, GDFT has shown better results than traditional fluid therapy to maintain hemodynamic stabilization Material and Methods: Our systematic review and meta-analysis was carried out according to the PRISMA guidelines for randomized studies. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until February 2022. All relevant outcomes were pooled in the meta-analysis using Review Manager Software Results: Our systematic review included three RCTs. All of them were included in our meta-analysis. There was no significant difference between GDFT group and the control group in the maternal adverse events except in the incidence of hypotension which was less in the intervention group. Also, there is no significant difference between the two groups in terms of PH, PO2, PCO2, lactic acid, and base deficit. GDFT group was better in SO2 than the control group in both artery and vein. Regarding the umbilical vein, the number of neonates who had PCO2 >46 mmHg and PO2 ≤21 mmHg was less in the intervention group than the control group. On the other hand, there were no significant difference between the two groups in the number of neonates whose PH <7.28. Finally, regarding the umbilical artery, the number of neonates who had PCO2 >46 mmHg and PO2 ≤21 mmHg was less in the intervention group. Conclusion: GDFT shows promising results in controlling the hypotension and blood gases in pregnant women compared with the control group. Also, GDFT may provide benefits to healthy parturient women and their newborns.