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Fluid Balance during Labour: A Review 1

Normal pregnancy induces progressive adaptations in every system, and it is against this background of altered maternal homeostasis that the giving of fluids during labour and delivery must be considered. At the present time labour usually lasts for less than 24 hours in women having their first baby and less than 12 hours in multigravid patients. During such a short interval healthy mothers normally will not develop problems of fluid balance; if problems do occur they are likely to follow the intravenous administratioh of excessive volumes of sodium-free fluids. In addition to maternal complications, the biochemical consequences of inappropriate fluid regimens will be reflected in the fetus although these may not become obvious until some time after the infant is born. Most information concerning the water status of pregnant women has been derived from studies undertaken at or near term, but some serial measurements have been reported; these data will be considered first. The major physiological changes which influence this status will then be considered individually.