Gynecology, Fort Bragg, NC. OBJECTIVE: To estimate the influence of maternal obstetric history on morbidity in pregnancies complicated by placenta previa ...
Poster Session IV
ajog.org 600 A randomized, double-blinded, controlled trial of the effects of rate and/or presence of dextrose on the labor course of nullipara
Table 1 Labor-related outcomes
Alex Fong1, Allison Serra1, Deysi Caballero2, Thomas Garite3, Vineet Shrivastava2 1
University of California, Irvine, Obstetrics and Gynecology, Orange, CA, Miller Children’s and Women’s Hospital, Long Beach, CA, 3Obstetrix/ Pediatrix Medical Group, Sunrise, FL 2
OBJECTIVE: To characterize the effects of rate and/or presence of dextrose in intravenous fluids on the labor course of nulliparas. STUDY DESIGN: We enrolled nulliparae with singletons who presented in active labor, defined as 3-5cm cervical dilation. Subjects were randomized to one of three groups of intravenous (IV) fluids: 250 mL/hr of normal saline (NS), 125 mL/hr of 5% dextrose in NS (D5NS), or 250 mL/hr of 2.5% dextrose in NS (D2.5NS). The primary outcome was total length of labor from initiation of IV fluid in vaginally delivered subjects. Secondary outcomes included cesarean delivery rate, length of second stage of labor, and other maternal and neonatal outcomes. Student’s t-test, Mann-Whitney U test, analysis of variance, and KruskalWallis test were used as indicated. Significance was set at p 24 weeks gestation from 1988 to 2011; the 2013 definition of incomplete and complete placenta previa was utilized for inclusion. Medical records were reviewed and pathology, demographic, obstetrical, and surgical data were collected. Sonographic images were reviewed by a single examiner to confirm placenta previa. Statistical analyses included evaluation for trend. RESULTS: A total of 209,020 women delivered at our institution during the study period. 444 singleton pregnancies with placenta previa were identified for an incidence of 2.1 per 1000 deliveries; 108 women (24%) underwent emergent peripartum hysterectomy. 388 patients had complete medical records available for review and were included in the full analysis. Women undergoing peripartum hysterectomy did not differ from those not requiring a hysterectomy in age, ethnicity, body mass index, or tobacco, alcohol, or drug use. With each additional prior cesarean section and increasing parity, pregnancies were more likely to be complicated by postpartum hemorrhage, blood transfusion, and peripartum hysterectomy (all P ¼
