Evidence‐based guidelines for intrapartum maternal hydration assessment and management: A scoping review

Lauren Kearney; Alison Craswell; Nellie Dick; Debbie Massey; Rachael Nugent

doi:10.1111/birt.12773

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Evidence‐based guidelines for intrapartum maternal hydration assessment and management: A scoping review

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Evidence‐based guidelines for intrapartum maternal hydration assessment and management: A scoping review

Lauren Kearney, Alison Craswell, Nellie Dick, Debbie Massey and Rachael Nugent

Birth (Berkeley, Calif.), Vol.51(2), pp.253-263

06/2024

DOI: https://doi.org/10.1111/birt.12773

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Abstract

birth

clinical variation

fasting in labor

hydration

hyponatremia

intrapartum care

intravenous therapy

labor

labor and birth management or care

Problem Inconsistent practice relating to intrapartum hydration assessment and management is reported, and potential harm exists for laboring women and birthing persons. Background Labor and birth are physically demanding, and adequate nutrition and hydration are essential for labor progress. A lack of clear consensus on intrapartum hydration assessment and management during labor and birth currently exists. In addition, there is an inconsistent approach to managing hydration, often including a mixture of intravenous and oral fluids that are poorly monitored. Aim The aim of this scoping review was to identify and collate evidence-based guidelines for intrapartum hydration assessment and management of maternal hydration during labor and birth. Methods PubMed, Embase, and CINAHL databases were searched, in addition to professional college association websites. Inclusion criteria were intrapartum clinical guidelines in English, published in the last 10 years. Findings Despite searching all appropriate databases in maternity care, we were unable to identify evidence-based guidelines specific to hydration assessment and management, therefore resulting in an “empty review.” A subsequent review of general intrapartum care guidelines was undertaken. Our adapted review identified 12 guidelines, seven of which referenced the assessment and management of maternal hydration during labor and birth. Three guidelines recommend that “low-risk” women in spontaneous labor at term should hold determination over what they ingest in labor. No recommendations with respect to assessment and management of hydration for women undergoing induction of labor were found. Discussion Despite the increasing use of intravenous fluid as an adjunct to oral intake to maintain maternal intrapartum hydration, there is limited evidence and, subsequently, guidelines to determine best practice in this area. How hydration is assessed was also largely absent from general intrapartum care guidelines, further perpetuating potential clinical variation in this area. Conclusion There is an absence of guidelines specific to the assessment and management of maternal hydration during labor and birth, despite its importance in ensuring labor progress and safe care.

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Title: Evidence‐based guidelines for intrapartum maternal hydration assessment and management: A scoping review
Creators: Lauren Kearney - University of Queensland
Alison Craswell - University of the Sunshine Coast
Nellie Dick - Sunshine Coast Hospital and Health Service
Debbie Massey - Edith Cowan University
Rachael Nugent - Sunshine Coast Hospital and Health Service
Publication Details: Birth (Berkeley, Calif.), Vol.51(2), pp.253-263
Publisher: John Wiley & Sons, Inc.
Identifiers: 991013143613302368
Copyright: © 2023 The Authors. Birth published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution License. Open access publishing facilitated by The University of Queensland, as part of the Wiley - The University of Queensland agreement via the Council of Australian University Librarians.
Academic Unit: Nursing; Faculty of Health
Language: English
Resource Type: Journal article

Evidence‐based guidelines for intrapartum maternal hydration assessment and management: A scoping review

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