Can Glucose Supplementation Shorten Labor in Induced Women?
A study published in the American Journal of Obstetrics & Gynecology reports that the total length of induced labor may be reduced with the use of glucose supplementation.
Prolonged labor contributes to maternal and fetal morbidity but not many interventions are established to decrease the course of labor. Researchers from the University of Sherbrooke sought to evaluate whether intravenous (IV) glucose supplementation during labor in nulliparous women could decrease total duration of active labor. They conducted a single center, prospective, double-blind, randomized-controlled trial comparing 250mL/hr intravenous (IV) dextrose 5% with normal saline vs. 250mL/hr normal saline in 200 induced-nulliparous women.
The primary outcome was the total duration of active labor and secondary outcomes included duration of the active phase of second stage labor, the mode of delivery, APGAR scores, and arterial cord pH.
The median total duration of labor was significantly shorter in the dextrose + normal saline group (499 minutes vs. 423 minutes; P=0.024) than in the normal saline group. The likelihood of a woman delivering at 200 minutes and 450 minutes was 18.8% and 77.1% in the dextrose + normal saline group vs. 8.2% and 59.8% in the normal saline group. "There was no difference in the rate of caesarean section, instrumented delivery, APGAR score or arterial cord pH," added study author Josianne Pare, MD.
In general, glucose supplementation significantly reduced the total length of labor without increasing the rate of complication in induced-nulliparous women. Study findings support the use of glucose as the default solute during labor given its low cost and safety profile.
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