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Tranmer, Joan Elizabeth,1953-
Nutritional support during labour :a randomized clinical trial of patient-controlled oral intake during labour.
Ph. D. -- University of Toronto, 1999
Ottawa :National Library of Canada = Bibliothèque nationale du Canada,[2000]
2 microfiches
Includes bibliographical references.
'Objective'. The purpose of this trial was to determine if a policy of unrestricted access to foods and fluids during labor was effective in reducing the incidence of dystocia, and in low risk milliparous, women. 'Study design'. A randomized clinical trial was conducted at a teaching hospital in southeastern Ontario. Three hundred and thirty low risk nulliparous women were randomized between 30-40 weeks gestation to either an intervention or usual cam group. Women in the intervention group received, prenatally, an information booklet containing guidelines about food and fluid intake during labor and were encouraged to eat and drink, as they pleased, and as was comfortable for them throughout labor. The oral protocol was discontinued if women received epidural analgesia or complications developed such that they were at risk for a caesarean section birth. Women in the usual care group were restricted to ice chips and water during labor. 'Results'. Three hundred and twenty eight women were randomized to either the control group (n = 165) or intervention group (n = 163). Of these women 78% (257/328) returned completed postpartum questionnaires. Women in the intervention group reported a significantly different pattern of oral intake, during early labor in the hospital ([chi]2 = 40.7, p < 001). Most women regulated their intake in response to feelings of nausea or discomfort. The incidence of dystocia was 36% (n = 58) in the intervention group and 44% (n = 72) in the usual care group and was not significantly different (OR = .71, 95% CI .46, 1.1). There were no significant differences in the other secondary outcomes measured or in the incidence of adverse maternal or neonatal complications. 'Conclusion'. Patient controlled oral intake during labor did not decrease the incidence of dystocia, was not associated with any adverse maternal or neonatal outcome and was enjoyed by women in labor. In the absence of benefit or harm women should be informed about the results of this trial in order to make their own decisions with regards to oral intake during labour. Further research is warranted to determine if a more prescriptive pattern of oral fluid intake during established labor is beneficial.