47 A Double-Blinded Randomized Controlled Trial on Increased Intravenous Hydration in Nulliparous Women Undergoing Labor Induction

Abstract

High-dose intravenous fluid (250cc/hr) has been previously demonstrated to shorten the time to delivery in nulliparous women in spontaneous labor. Whether or not this relationship ship exists in women undergoing induction of labor is unknown. Our study aimed to evaluate the effect of high-dose intravenous hydration (compared to standard dose) on time to delivery among nulliparous women undergoing induction of labor. Nulliparous women presenting for induction of labor with a Bishop score of less than or equal to 6 (with and without rupture of membranes) were randomized to receive either 125cc/hr or 250cc/hr of normal saline. The primary outcome was length of labor (defined as time from initiation of study fluids to delivery). Both time to overall delivery and vaginal delivery were evaluated. Secondary outcomes included the lengths of each stage of labor, the percentage of women delivering within 24 hours, and maternal and neonatal outcomes. 180 individuals meeting inclusion criteria were enrolled and randomized. Baseline demographic characteristics were similar between groups, however there was a higher incidence of maternal diabetes in the group receiving 125cc/hr. Average length of labor was similar between groups (27.6hr in 250cc/hr and 27.8hr in 125cc/hr) as was the length of each stage of labor. Cox regression analysis did not demonstrate an effect of fluid rate on time to delivery. Neither admission bishop score, BMI, nor other demographic characteristics impacted time to delivery or vaginal delivery. There were no differences in maternal or neonatal outcomes including overall cesarean rate, clinical iatrogenic intrapartum infection, Apgar scores, need for neonatal phototherapy, or neonatal intensive care unit stay. There are no observed differences in the length of labor or maternal or neonatal outcomes with the administration of an increased rate of intravenous fluids among nulliparous women undergoing induction of labor.