Neonatal electrolyte response to amnioinfusion with lactated Ringer's solution vs. normal saline. A prospective study

Abstract

Objective: To determine if amnioinfusion with normal saline vs. lactated Ringer's solution crystalloids causes electrolyte imbalance in the human neonate.

Study design: Over two months, all parturients undergoing amnioinfusion in the active phase of labor were prospectively randomized to receive either normal saline (n = 37) or lactated Ringer's solution (n = 30). Maternal electrolytes were obtained prior to amnioinfusion, and neonatal electrolytes were obtained from cord blood samples at the time of delivery.

Results: Our results showed the two groups were similar in maternal age, ethnicity, gravidity, parity, gestational age, maternal electrolyte levels prior to amnioinfusion, amount of solution amnioinfused, duration of labor after amnioinfusion, mode of delivery and mean birth weight. The chloride concentrations were nearly identical among neonates who had received normal saline and those who had received lactated Ringer's solution (102 +/- 2.1 SD and 104 +/- 2.4 mmol/L, respectively; P = 1.0). Other electrolytes were likewise not significantly different regardless of the crystalloid infused.

Conclusion: Unlike the fetal sheep model, amnioinfusion with normal saline is not associated with hyperchloremia in the human neonate.