An Australian and Aotearoa New Zealand Audit of Obstetric Fluid Management During Induction of Labor

Abstract

Background: Although guidelines are in place for obstetric indications that warrant an induction of labor, no such guidelines or policies exist for the management of fluids during labor. This extends to the concentration of oxytocin used for induction, maintenance rate of intravenous crystalloids and subsequent boluses of this crystalloid. The aim of this survey was to obtain a snapshot of current Australian and Aotearoa New Zealand obstetric practice as it pertains to fluid management during induction of labor.

Methods: A REDCap survey was made available to medical practitioners registered with the Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG) via email.

Results: A total of 287/6,707 (4.3%) medical practitioners registered with RANZCOG completed the survey. A response was received from medical practitioners in all states and territories of Australia and Aotearoa New Zealand, from a total of 140 hospitals. The majority of respondents were consultants (178/287 (62%)). Variability was noted for the concentration of oxytocin that was used. Three different types of crystalloid were used. Marked variability was noted for the rate of infusion of crystalloid, the indications for a bolus of crystalloid and the size of this bolus.

Conclusions: The management of fluid during induction of labor has marked variability both in Australia and Aotearoa New Zealand, suggesting that a policy to guide this management does not exist, and best practice has not been identified.

J Clin Gynecol Obstet. 2023;12(3):71-77
doi: https://doi.org/10.14740/jcgo924