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A double-blind, randomised, placebo controlled study on the influence of carbohydrate solution intake during labour.

OBJECTIVE: Although there has been much debate on whether women should be allowed to eat and drink during labour, little scientific data are available on the effects of caloric intake on the course of labour. DESIGN: Double-blind, randomised, placebo controlled. SETTING: Leyenburg Hospital, The Hague, The Netherlands. POPULATION: Two hundred and one consecutive nulliparous women, pregnant of a single fetus in cephalic presentation. METHODS: All women were included in early labour (2cm-4cm of cervical dilatation) and were allowed to drink at will. MAIN OUTCOME MEASURES: The duration of labour, the need for augmentation and pain medication and the incidence of abdominal and vaginal instrumental deliveries. RESULTS: Drinking of carbohydrate solutions was well tolerated, but did not show any beneficial effects regarding labour outcome when compared with the control group. In the carbohydrate group, a higher caesarean section rate was observed (RR 2.9, 95% CI 1.29-6.54). CONCLUSIONS: Women in the carbohydrate group had worse labour outcome. It is unclear whether a statistical coincidence, a negative effect of the carbohydrate intake or an incorrect carbohydrate intake strategy is responsible for these results. Further studies are necessary before any definite conclusion can be drawn.

Adult↗

[Relations between psycho-physical acceleration and modern obstetrics].

In the highly developed countries, an acceleration of human growth and an increase in body length can be observed. The weight and length at birth are also increasing, which can be proved by our own investigation. Up to now, the theories explaining this phenomena are insufficient, because they assume the transmission of genetically acquired qualities. The reason for the acceleration is to be considered in the advancement of obstetrics as follows: Obstetrical handling, forceps and caesarean section permit the delivery of large babies, which were often lethal for mother and child. This led to an increase in the frequency of genetic developments for greater body length and weight at birth, which had formerly been limited by the high mortality rate. The trend towards larger babies is caused by an evolutionary selection of an enlargement of the brain, which must reach a certain minimum size by the time of birth. The relative enlargement of the newborn skull, made possible by advanced obstetrics, permits such increased birth weight and length. It also leads to an acceleration of growth and taller adults. The consequence of larger babies is an increasing frequency of obstetrical operations.

Birth Weight↗