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trabalhos interessantes IVFrom: Jaime (jaimen@zaz.com.br)Mon, 5 Feb 2001 22:10:55 -0200
Aos colegas da lista Um hidratação adequada encurta significativamente o trabalho de parto em primigestas, diminuindo a necessidade de ocitócicos e a incidência de cesareanas. Dr. Thomas J. Garite coordenou um estudo com primigestas saudáveis, dilatação entre 2 e 5 cm e apresentação cefálica. Dividiu em 2 grupos e administrou ao primiero grupo 125ml/hora e ao segundo grupo 250ml/h. O estudo englobou 195 pacientes. Conclusões: 1- 26% das pacientes do grupo com menor hidratação, experimentou trabalho de parto superior a 12hs, contra 13% do grupo com maior hidratação. 2- 65% das pacientes do grupo de 125ml precisou de ocitocina por inadequada progressão, comparado com 49% do grupo de 250ml 3- No grupo de 125ml foram necesárias mais cesareanas, 16 contra 10 do grupo de 250ml Mais detalhes WESTPORT, CT (Reuters Health) Jan 31 - Increased intravenous hydration for nulliparous women reduces the frequency of prolonged labor and might lower the need for oxytocin. Dr. Thomas J. Garite and colleagues, from the University of California Irvine Medical Center in Orange, studied 195 nulliparous women "with uncomplicated singleton gestations at term, in spontaneous active labor with dilatation between 2 cm and 5 cm, and with a cephalic presentation," as they explain in the American Journal of Obstetrics and Gynecology for December. Ninety-four patients were randomly assigned to receive 125 mL of intravenous fluid per hour, while the remaining 101 patients were assigned to receive 250 mL. The mean volume of total intravenous fluids was significantly greater in the 250-mL group than in the 125-mL group, at 2487 mL and 2008 mL, respectively. The mean rate of administration was also significantly greater in the 250-mL group. The investigators report that 26% of patients in the 125-mL group experienced labor lasting more than 12 hours, compared with 13% of patients in the 250-mL group. This difference was statistically significant, they determined. "There was a trend favoring longer mean duration of the first stage and total duration of labor in patients delivered vaginally in the 125-mL group, by 70 and 68 minutes, respectively." Sixty-one patients (65%) in the 125-mL group received oxytocin for inadequate labor progress, compared with 51 patients (49%) in the 250-mL group, according to the team. Further, cesarean deliveries were more frequent in the 125-mL group than in the 250-mL group, at 16 and 10, respectively. "Inadequate hydration in labor may be a factor contributing to dysfunctional labor and possibly cesarean delivery," Dr. Garite and colleagues conclude. "This finding, if supported by further studies, has implications for labor management and for future studies on strategies to improve the progress of labor and avoid unnecessary cesarean deliveries." Am J Obstet Gynecol 2000;183:1544-1548.
-- Jaime Nonato http://www.jaimenonato.com jaimen@zaz.com.br
Voltar para Administrador da lista: flavio.monteiro.desouza@obgyn.net Solicitações à lista: obstet-l-request@obgyn.net Última atualização: Mon May 19 16:34:08 2008 |
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