Event Details
Zoom Meeting
20 March 2024
12:30pm - 1:30pm AEDT
20 March 2024
– 20 March 2024
Zoom Meeting
20 March 2024
12:30pm - 1:30pm AEDT
20 March 2024
– 20 March 2024
Presenters:
Darren Lowen
Head of Anaesthesia Research
Darren has a BSc.(Hons.) & PhD from La Trobe University. He was Postdoctoral Fellow at Peter MacCallum Cancer Institute, where he developed a mouse model of metastatic spread of cancer. He completed the Graduate Medical Program at The University of Sydney & Anaesthetic training at St Vincent’s Hospital, Melbourne; obtaining his Fellowship in 2014. Since 2016 he has been a staff anaesthetist at The Northern Hospital. In addition to obstetric and anaesthetic research, he initiated & is a co-investigator with the surgical head of research for a multi-site study aimed to show non-inferiority for the development of symptomatic DVT.
Event Dates
Date: 20 March 2024
Time: 12:30pm – 1:30pm AEDT
Date: 20 March 2024 – 20 March 2024
Location
Zoom Meeting
Variability in Fluid Management during Induction of Labour
Maternity Unit Managers
Zoom Meeting
About
Throughout Australia and New Zealand, there is extensive variability in practice, as it pertains to fluid management during induction of labour as indicated in the following three areas:
- There are at least 11 different concentrations of oxytocin being used
- There are at least 3 different types of crystalloids being used as both background IV infusion and as the carrier solution for oxytocin
- There are at least 5 different indications during induction of labour, which may or may not result in an IV bolus of the crystalloid, the bolus size varies from 100 ml to 1000 ml.
With regards to point 3, there are no biological or physiological reasons to justify this practice in the first place and I will present a model/hypothesis as to why I believe that providing IV boluses of fluid may be impacting negatively upon birth outcomes and contributing to an increase in the incidence of emergency caesarean sections, the incidence of an instrumental delivery, the increased incidence of requiring epidural analgesia and the increased incidence of neonatal admission to the special care nursery.
We cannot reduce variability in practice with regards to point 1 and point 2 probably doesn't make all that much difference. However, we can reduce variability with regards to point 3, but first of all we need to know the incidence of the practice of providing an IV bolus of fluid during IOL. By participating within a national audit of practice, which will take midwives less than 1 minute to complete, we obtain a better understanding of this practice and therefore we will be in a better position to provide education about this practice and hopefully implement change, which may lead to a dramatic improvement in obstetric outcomes and hopefully better work satisfaction and staff retention.
- Currently, extreme variability exists as it pertains to fluid management during induction of labour
- This variability may be contributing to an increase in the requirement for an instrumental delivery or emergency caesarean section, as well as increased analgesic requirements
- By participating within a national audit, we can make a difference!
