Leah Casey, RN, DNP, CRNA

DNP Nurse Anesthesia

Measuring the Effect of Oral Nutrition in Low-Risk Parturients

Project Category: Evidence Implementation  

Project Team: Leah Casey, DNP, CRNA, Maire Nakada, DNP, CRNA, Stephen Flaherty, CRNA, Ph.D. (Advisor)

Abstract

Background: Current labor diet guidelines of clear liquids or nil per os (NPO) status are outdated and warrant reassessment for potential liberation. Aspiration of gastric contents during labor is exceptionally rare and cannot be utilized as a primary outcome measure when weighing the risks and benefits of advancing oral intake for parturients.

Methods:  A retrospective chart review was conducted at a midwestern community hospital utilizing data of parturients (n=113) who were allowed varying diets throughout their labor. Primary outcomes were collected and grouped into NPO and oral intake. Outcome measures included incidence of gastric aspiration, antiemetic use, method of delivery, estimated blood loss (EBL), need for augmentation, and length of the second stage of labor.

Results: Obstetric providers ordered an NPO diet restriction for 50.4% of the sampled parturients followed by a regular diet at 31.9% and clear liquids at 16.8%.  EBL and antiemetic use were significantly higher in the NPO group (μ=515.37, σ=446.23, p<0.001). Delivery method, necessity for labor augmentation, and length of second stage of labor showed no significant differences between NPO and oral intake group.

Conclusion: Pulmonary aspiration did not occur during labor for any of the parturients in this study and is not a valid outcome measure to determine the safety of advancing parturient diet. The NPO group had a statistically significant higher EBL than the oral intake group. Advancing oral dietary intake did not statistically significantly increase incidences of other outcome measures.