Neonatal and maternal hyponatremia: comparison of oxytocin in dextrose 5 % infusion with oxytocin in saline infusion for induction of labor

ABSTRACT

We performed a randomized controlled trial of a total of 200 women in labor divided into two equal groups, to determine prospectively the relation between maternal and cord serum sodium levels and the effect of intravenous Oxytocin infusion in either dextrose 5 percent or saline. There was no maternal or neonatal hyponatremia in the saline group. Oxytocin in 5 percent Glucose infusion caused statistically significant depression of maternal and cord serum sodium levels, compared to those of the saline group. Eight newborns in dextrose 5 percent group [8 percent] had definite hyponatremia [< 130mmol/L]. We observed significant negative correlation between cord serum sodium and both the dose of Oxytocin and volume of glucose solution infused in the dextrose 5 percent group. Comparing the serum sodium levels in mothers and newborns between those women who received volumes of saline or dextrose 5 percent less than 1000ml and those who received more than 1000ml revealed statistically significant depression of serum sodium level in only more than 1000 ml dextrose 5 percent group. We recommended that caution should be exercised in prescribing intravenous Oxytocin therapy during labor and, if more than 1000ml of fluids are required, sodium should be included