A comparative study on the effect of intravenous Ringer lactate at 125 ml/hour versus 250 ml/hour on the duration of labour in nulliparous pregnant women

Background: Several factors may influence the progression of normal labour. It has been postulated that the routine administration of intravenous fluids to keep women adequately hydrated during labour may reduce the period of contraction and relaxation of the uterine muscle, and may ultimately reduce the duration of the labour. However, the routine administration of intravenous fluids to labouring women has not been adequately studied although it is widely practiced, and there is no consensus on the type or volume of fluids that are required, or indeed, whether intravenous fluids are at all necessary. This study was conducted to study the effect of intravenous Ringer lactate at 125 ml/hour versus 250 ml/hour on the duration of labour.Methods: In the study, patients were divided in two groups of nulliparous pregnant women in spontaneous early labour (between 3-5 cm dilatation), at term with singleton pregnancy and cephalic presentation, where one group received intravenous Ringer lactate at 125 ml/hour and the other group received Ringer lactate at 250 ml/hour. The duration of labour, mode of delivery and caesarean rates were measured in both groups along with incidence of prolonged labour and need for oxytocin augmentation.Results: The incidence of prolonged labour and oxytocin augmentation were less in the group receiving intravenous RL at 250 ml/hour but was not statistically significant. Remaining outcomes were comparable in both the groups with no outcome reaching statistical significance.Conclusions: Rate of fluid administration is one of the many variables which affects the labour outcomes. The incidence of prolonged labour and oxytocin augmentation was less in the group which received intravenous RL 250 ml/hour. There was no statistically significant difference in both groups in respect of duration of labour, mode of delivery and caesarean rates.

The Isolated Oligohydramnios

Amniotic fluid is an indicator of normal placental function and is essential for normal fetal lung maturation. Amniotic fluid index (AFI) is the most preferred method of amniotic fluid measurement in pregnancy although single deepest pocket (SDP) is also used. To measure AFI, the examiner divides the uterus into four equal quadrants. AFI is the sum of deepest pocket from each quadrant. The normal AFI ranges between 5~24 cm while any value above 24 cm is considered as hydramnios and that below 5 cm is indicated as oligohydramnios. An adequate volume of amniotic fluid is critical to allow normal fetal movement and growth, while also cushioning the fetus and umbilical cord. Regardless of the etiology, oligohydramnios may inhibit these processes and may lead to fetal deformation, umbilical cord compression, and death in some instances. Oligohydramnios can be due to underproduction, loss, or sometimes, isolated. Isolated oligohydramnios has been found to be responsive maternal hydration and is neither a malformation of the urinary system in the fetus, nor a rupture of amnion and due to genetic cause. The author would like to introduce a way to increase amniotic fluid volume in isolated oligohydramnios which is expect to improve the perinatal outcomes.

Effects of combination of maternal hydration and hands and knees posture on nursing of breech pregnancy / 中国实用护理杂志

Objective To compare the effects of combination of maternal hydration and hands and knees posture with simple hands and knees posture on correction of breech pregnancy. Methods One hundred patients who were diagnosed breech pregnancy from November 2015 to November 2016 were assigned to experimental group and control group with 50 cases each according to individual willingness. The patients in experimental group received the combination of maternal hydration and hands and knees posture;while the patients in control group received simple hands and knees posture. Results Amniotic fluid index was (18.94±2.44)cm in experimental group and (15.97±2.33)cm in control group, the difference had statistic significance (t=6.239, P<0.05). The effective transfer rate and successfully used time was 92%(46/50) , (2.10 ± 0.75) weeks in experimental group and 64%(32/50), (4.27 ± 0.98) weeks in control group, the difference had statistic significance (χ2=11.422, P<0.05; t=-12.463, P<0.05). For primipara and multipara, the effective transfer rate was 90.91%(30/33), 16/17 in experimental group, and 68.75%(22/32), 10/18 in control group, the difference had statistic significance (χ2=4.986, 6.806, all P<0.05). The rate of vaginal and cesarean section deliveries was 86%(43/50), 14%(7/50) in experimental group, and 56%(28/50), 44%(22/50) in control group, the difference had statistic significance(χ2=10.928, P=0.001). Patients who had fetal movement or who didn′t have time to do correction or missed was 17.10%(46/269), 1.49%(4/269) in experimental group, and 12.55% (22/255), 7.06% (18/255) in control group. Conclusions @Therapic effects of combination of maternal hydration and hands and knees posture is much better than that of the simple hands and knees posture therapy on correction of breech pregnancy, which is worthy of popularization and application in clinic.