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Poster Session 3

Category: Practice Management

Poster Session 3

(941) Impact of a national shortage-based intravenous fluid-restrictive protocol on delivery outcomes

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Sara I. Jones, MD (she/her/hers)

Clinical Fellow
Duke University School of Medicine
Durham, North Carolina, United States

Coauthor(s)

CX

Chun Xu, MS

Duke University Medical Center
Durham, North Carolina, United States
TT

Tracy Truong, MS

Biostatistician
Duke University Medical Center
Durham, North Carolina, United States
OM

Osinakachukwu Mbata, MD

Clinical Fellow, Division of Maternal-Fetal Medicine
Duke University Health
Durham, North Carolina, United States
Lillian Boettcher, MD (she/her/hers)

Clinical Fellow, Division of Maternal-Fetal Medicine
Duke University School of Medicine
Durham, North Carolina, United States
Rachel L. Wood, MD (she/her/hers)

Assistant Professor of Obstetrics and Gynecology
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University
Durham, North Carolina, United States
Brenna L. Hughes, MD (she/her/hers)

Professor
Department of Obstetrics and Gynecology, Duke University School of Medicine
Duke, North Carolina, United States

Objective:
Intravenous hydration is a common practice on US L&D units, though general medicine literature recommends limited use due to adverse morbidity. In the fall of 2024, a national intravenous fluid (IVF) shortage led to IVF restriction for laboring and postpartum patients; however, effects of this change are poorly understood. We aimed to assess delivery, obstetric, and neonatal outcomes associated with IVF fluid restriction.

Study Design:
We performed a pre- and post- analysis of patients delivering at a single tertiary health system in temporal proximity to the IVF protocol change. Restrictions in IVF use at our institution related to the 2024 Baxter Fluid Shortage began October 3, 2024; this protocol included no continuous IV fluids compared to the prior standard 75ml/hr. Primary exposure was delivery after protocol implementation after a 2-week washout (October 15 2024-April 30 2025) compared to deliveries in a pre-fluid restriction (October 15 2023-April 30 2024) period. Primary outcome were delivery outcomes. Secondary outcomes were maternal complications and neonatal outcomes. Chi-square tests and t-tests were used for analysis.

Results:
There were 3560 deliveries in the pre-restriction and 3564 in the IVF-restriction group following the washout period. There were no differences in maternal age or ethnicity between groups with a statistically but not clinically significant difference in race and payor status between groups (Table 1). There was no difference in cesarean delivery rate (37.4% versus 37.0%), intraamniotic infection (8.9% versus 8.4%), OASIS tear (2.1% vs 1.9%), or pulmonary edema (0.1% vs 0.2%) before versus during the IVF-restrictive period (Figure 1). No differences were found in neonatal outcomes.

Conclusion:
An IVF-restrictive protocol utilized during a national shortage was not associated with a higher rate of cesarean delivery or adverse delivery or neonatal outcomes. This should be considered when developing strategies to minimize unnecessary interventions with potential adverse outcomes and to reduce healthcare waste.