{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T20:21:58Z","timestamp":1775679718901,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,8,12]],"date-time":"2018-08-12T00:00:00Z","timestamp":1534032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009725","name":"Wishlist","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To describe contemporary routine practice regarding rapid pre\u2010loading of intravenous fluid management prior to epidural analgesia during labour and birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Midwives are the key health professionals providing care for women before, during and after an epidural in labour. Part of this management involves maternal hydration; however, how midwives assess and manage maternal hydration and fluid management is not well understood. Prior to the administration of a low dose epidural for pain relief a rapid intravenous pre\u2010loading of between 500\u20101000\u00a0mls of crystalloid fluids is administered to the pregnant women. Currently, there is limited evidence available to assess if intravenous pre\u2010loading reduces maternal hypotension and foetal bradycardia. Anecdotal evidence suggests that wide variation in clinical practice in relation to volume of fluid administered, fluid status assessment and clinical documentation occurs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective medical health record review, in a regional Australian maternity hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective medical health record review chart review from women who received an epidural for pain relief during labour and birth (June\u2013September 2015).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 293 charts were collected, including: maternal factors; blood pressure distributions; maternal fluid status; types, concentration and timing of analgesia loading doses; <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> fluid loading volumes; maternal hypotension, foetal outcomes and documentation of fluid balance charts. Wide variation in clinical practice was evident with midwives administering pre\u2010loading fluid volumes ranging from 250\u20101000\u00a0ml. Midwifery assessment, documentation and practice pertaining to hydration was inconsistent and lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Management of intravenous fluids during labour is fragmented. Although fluid balance charts are used internationally to assess maternal hydration, documentation of fluid balance status was poor. Multi\u2010professional collaboration between obstetrics, anaesthetics and midwifery is required to address this wide variation and reach consensus on best practice based on what evidence is currently available.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jan.13783","type":"journal-article","created":{"date-parts":[[2018,7,2]],"date-time":"2018-07-02T13:22:03Z","timestamp":1530537723000},"page":"2588-2595","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["How midwives manage rapid pre\u2010loading of fluid in women prior to low dose epidurals: A retrospective chart review"],"prefix":"10.1111","volume":"74","author":[{"given":"Hannah","family":"Lindstrom","sequence":"first","affiliation":[{"name":"Sunshine Coast Hospital and Health Service Britinya QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0299-6537","authenticated-orcid":false,"given":"Lauren","family":"Kearney","sequence":"additional","affiliation":[{"name":"Sunshine Coast Hospital and Health Service Britinya QLD Australia"},{"name":"University of the Sunshine Coast Sippy Downs QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0466-1960","authenticated-orcid":false,"given":"Debbie","family":"Massey","sequence":"additional","affiliation":[{"name":"University of the Sunshine Coast Sippy Downs QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Godsall","sequence":"additional","affiliation":[{"name":"Sunshine Coast Hospital and Health Service Britinya QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Hogan","sequence":"additional","affiliation":[{"name":"Sunshine Coast Hospital and Health Service Britinya QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,8,12]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"National Safety and Quality Health Service Standards","author":"Australian Commission on Safety and Quality in Health Care","year":"2012"},{"key":"e_1_2_10_3_1","unstructured":"Australian Institute of Health and Welfare. (2016).Perinatal data portal: Labour and birth analgesia and anaesthesia. Retrieved fromhttp:\/\/analytics.aihw.gov.au\/Viewer\/VisualAnalyticsViewer_guest.jsp?reportPath=%2FAIHW%2FReleasedPublic%2FPerinatal%2FReports%2FNOV2016&reportName=Labour%20and%20birth%20-%20Analgesia%20and%20anaesthesia&reportViewOnly=true&viewerMode=modern&commentsEnabled=false&propertiesEnabled=false&appSwitcherDisabled=true"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2663"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","unstructured":"Dawood F. Dowswell T. &Quenby S.(2013).Intravenous fluids for reducing the duration of labour in low risk nulliparous women. 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(2014b).Intravenous fluid therapy in adults in hospital: quality standard. Retrieved fromhttp:\/\/nice.org.uk\/guidance\/qs66"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-4358-6-9"},{"key":"e_1_2_10_18_1","unstructured":"Queensland Health. (2017).Queensland clinical guidelines: Epidural analgesia in labour.Brisbane."},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcg101"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","unstructured":"Singata M. Tranmer J. &Gyte G. M. L.(2013).Restricting oral fluid and food intake during labour. Cochrane Database of Systematic Reviews (8). doi:10.1002\/14651858.CD003930.pub3","DOI":"10.1002\/14651858.CD003930.pub3"},{"key":"e_1_2_10_21_1","unstructured":"State of Queensland (Queensland Health). (2016).Hypertensive disorders of pregnancy. 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