From the Research
D5LR intrauterine infusion is not recommended due to the potential risks of infection, fluid overload, electrolyte imbalances, uterine irritation or trauma, allergic reactions, and disruption of an early undiagnosed pregnancy, as evidenced by various studies 1, 2, 3, 4, 5. The primary risks associated with D5LR intrauterine infusion include:
- Infection, which can lead to endometritis or pelvic inflammatory disease due to introducing pathogens into the sterile uterine environment
- Fluid overload, particularly in patients with cardiac or renal issues, as the fluid may be absorbed systemically
- Electrolyte imbalances, which can occur from the lactated Ringer's component, potentially causing metabolic disturbances
- Uterine irritation or trauma, which may result from the catheter insertion, leading to cramping, bleeding, or in rare cases, uterine perforation
- Allergic reactions to components of the solution, which are possible, though uncommon
- Disruption of an early undiagnosed pregnancy, if the procedure is performed without proper screening Additionally, the dextrose component may create an environment favorable for bacterial growth if aseptic technique is compromised. According to the most recent and highest quality study 5, IV Ringer's lactate during labor was found to reduce the duration of active labor, the need for oxytocin augmentation, and the incidence of prolonged labor, but it did not differ in effect on immediate neonatal health. However, it is essential to weigh these potential benefits against the risks associated with D5LR intrauterine infusion and consider alternative treatments or procedures that may be safer and more effective. In real-life clinical practice, it is crucial to prioritize the patient's safety and well-being, and the use of D5LR intrauterine infusion should be avoided due to the potential risks and limited benefits.