{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T03:21:19Z","timestamp":1764645679677,"version":"3.40.5"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evidence regarding the type and rate of intravenous (IV) fluid administration during labor is still inconclusive and the studies assessing the impact of IV fluids had mixed results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the effects of IV fluids at an infusion rate of 250\u2009mL\/h as compared with 125\u2009mL\/h on labor outcomes in nulliparous women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search Strategy<\/jats:title><jats:p>We searched six databases for relevant studies through a search strategy containing the relevant keywords \u201cIV hydration\u201d, \u201cIV fluids\u201d, and \u201clabor\u201d from the inception of these databases to May 1, 2023, without any applied restrictions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection Criteria<\/jats:title><jats:p>Search results were imported to Covidence for screening of eligible articles for this review. Randomized controlled trials (RCTs) assessing the impact of IV fluids at 250\u2009mL\/h on the outcomes of labor in nulliparous women at term (&gt;37\u2009weeks) as compared with 125\u2009mL\/h were included only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection and Analysis<\/jats:title><jats:p>Data regarding the characteristics of included studies, participant's baseline characteristics, and concerned outcomes were collected in an Excel spreadsheet and all the concerned outcomes were pooled as risk ratios (RR) or mean difference (MD) with 95% confidence interval (CI) in the meta\u2010analysis models using RevMan 5.4.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Pooled data from 11 RCTs with 1815 patients showed that 250\u2009mL\/h infusion rate had a significant reduction in cesarean section rate (RR 0.70, 95% CI 0.56\u20130.88, <jats:italic>P<\/jats:italic>\u2009=\u20090.002), the first stage of labor duration (MD \u201346.97, 95% CI \u201381.79 to \u221212.14, <jats:italic>P<\/jats:italic>\u2009=\u20090.008), the second stage of labor duration (MD \u20132.69, 95% CI \u20134.34 to \u22121.05, <jats:italic>P<\/jats:italic>\u2009=\u20090.001), prolonged labor incidence (RR 0.72, 95% CI 0.58\u20130.89, <jats:italic>P<\/jats:italic>\u2009=\u20090.003), as compared with 125\u2009mL\/h. Also, the vaginal delivery rate (RR 1.07, 95% CI 1.02\u20131.12, <jats:italic>P<\/jats:italic>\u2009=\u20090.009) was higher with a 250\u2009mL\/h infusion rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IV fluids at an infusion rate of 250\u2009mL\/h during labor in nulliparous women decreased the cesarean delivery rate, increased the vaginal delivery rate, shortened the first and second\u2010stage labor duration, decreased the incidence of prolonged labor as compared with 125\u2009mL\/h. These findings suggest enhanced labor progression and a lower risk of labor complications with higher infusion rates. However, future research involving a more diverse population and exploring the potential benefits of combining IV infusion rates with other interventions, such as adding dextrose or less restrictive oral intake during labor, is needed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15198","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T11:55:26Z","timestamp":1697716526000},"page":"621-633","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Intravenous fluid rate of 250\u2009mL\/h versus 125\u2009mL\/h in nulliparous women: A systematic review and meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"165","author":[{"given":"Muhammad","family":"Imran","sequence":"first","affiliation":[{"name":"University College of Medicine and Dentistry, University of Lahore  Lahore 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