The Association Between Fluid Administration, Oxytocin Administration, and Fetal Heart Rate Changes
| Status: | Terminated |
|---|---|
| Conditions: | Women's Studies |
| Therapuetic Areas: | Reproductive |
| Healthy: | No |
| Age Range: | 18 - 60 |
| Updated: | 10/26/2017 |
| Start Date: | September 2007 |
| End Date: | July 2012 |
Fetal heart rate patterns are an important parameter in the diagnosis of non-reassuring fetal
status. Combined-spinal epidural analgesia is a method of initiating labor analgesia used by
approximately 90% of the parturients at Prentice Women's Hospital. Optimizing the variables
which could affect fetal heart rate patterns at the time of initiation of analgesia, such as
fluid administration and oxytocin management, could help us provide better care for our
patients and their fetuses.
Hypotheses: The combination of fluid administration and lower doses of oxytocin
administration will have fewer adverse fetal heart rate changes in the first 60 minutes
following initiation of labor analgesia.
status. Combined-spinal epidural analgesia is a method of initiating labor analgesia used by
approximately 90% of the parturients at Prentice Women's Hospital. Optimizing the variables
which could affect fetal heart rate patterns at the time of initiation of analgesia, such as
fluid administration and oxytocin management, could help us provide better care for our
patients and their fetuses.
Hypotheses: The combination of fluid administration and lower doses of oxytocin
administration will have fewer adverse fetal heart rate changes in the first 60 minutes
following initiation of labor analgesia.
After obtaining informed, written consent, candidates were randomized to one of four groups
at the time of request for labor analgesia. All subjects received a maintenance infusion of
Lactated Ringers(LR). For candidates in Groups A or B, an intravenous bolus of 1000 mL of LR
was initiated. Candidates in Groups C and D did not receive any additional fluid. If
randomized to group A or C, the oxytocin management was continued as per the normal active
management of labor protocal (AMOL). If randomized to groups B or D, the dose of oxytocin
that was being administered was halved and not increased until 60 minutes after the
initiation of epidural analgesia. Fetal heart rate monitoring and frequency of uterine
contractions were recorded by external tocodynamometry.
at the time of request for labor analgesia. All subjects received a maintenance infusion of
Lactated Ringers(LR). For candidates in Groups A or B, an intravenous bolus of 1000 mL of LR
was initiated. Candidates in Groups C and D did not receive any additional fluid. If
randomized to group A or C, the oxytocin management was continued as per the normal active
management of labor protocal (AMOL). If randomized to groups B or D, the dose of oxytocin
that was being administered was halved and not increased until 60 minutes after the
initiation of epidural analgesia. Fetal heart rate monitoring and frequency of uterine
contractions were recorded by external tocodynamometry.
Inclusion Criteria:
- Age 18-60
- Healthy nulliparous or multiparous women
- Term (>36 week gestation)
- Singleton pregnancy
- Spontaneous labor or with spontaneous rupture of membranes
- Receive oxytocin
- Request neuraxial analgesia
Exclusion Criteria:
- Under 18 years of age
- Presence of any systemic disease (e.g., diabetes mellitus, hypertension, preeclampsia)
- Use of chronic analgesic medications
- Prior administration of systemic opioid labor analgesia
- Non-vertex presentation
- Induction of labor
- Contraindication to neuraxial analgesia.
We found this trial at
1
site
Click here to add this to my saved trials
