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Poster Session 4

Category: Hypertension

Poster Session 4

(1274) Implementation of Restricted Labor IV Fluid Protocol and Development of Pregnancy Associated Hypertension

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Talia Suner, MD

Maternal Fetal Medicine Fellow
Ochsner Clinic Foundation
New Orleans, Louisiana, United States

Coauthor(s)

TS

Turner Simmers

Ochsner Clinic Foundation
New orleans, Louisiana, United States
BJ

Brian James, MD

Ochsner Clinic Foundation
New Orleans, Louisiana, United States
JT

James D. Toppin, MD, MPH

Fellow
Ochsner Clinic Foundation
New Orleans, Louisiana, United States
Joseph R. Biggio, Jr., MD (he/him/his)

System Chair, Women's Services
Ochsner Health
New Orleans, Louisiana, United States
Frank B. Williams, MD, MPH (he/him/his)

Ochsner Clinic Foundation
Ochsner Clinic Foundation, Louisiana, United States
BN

Barbara Neuhoff, MD

Ochsner Clinic Foundation
New Orleans, Louisiana, United States

Objective:
Routine labor management includes bolus and maintenance IV fluids to maintain maternal euvolemia and uterine perfusion. To adapt to the recent national IV fluid shortage, our hospital implemented a restricted labor IV fluid protocol. We hypothesize that decreased IV fluid volume administration during labor will lead to a lower incidence of pregnancy associated hypertension (PAH) diagnosed intrapartum or postpartum.

Study Design:
We performed a retrospective cohort study of patients during their delivery admission at a single tertiary hospital from May 1, 2024, to May 1, 2025. Included were nulliparous, term patients with a vertex presentation admitted for labor management. Patients with PAH at the time of admission were excluded. We compared patients pre- and post-implementation, which started October 1, 2024. The primary outcome was intrapartum or postpartum PAH, defined as gestational hypertension or preeclampsia. Secondary outcomes included postpartum readmission for hypertension, cesarean delivery, 5-minute Apgar scores, and neonatal intensive care (NICU). Baseline characteristics and outcomes were compared via chi square or Mann-Whitney U test where appropriate. Relative risks (RR) were generated with 95% confidence intervals (CI). Alpha was set at 0.05.

Results:
Among 996 nulliparous patients with singleton term pregnancies, 558 (56%) delivered after October 1, 2024. Blood loss was decreased post-implementation, but this difference was not clinically significant. No other differences in baseline characteristics were observed between groups (table 1). Diagnosis of PAH intrapartum or postpartum did not change following implementation of the restricted IV fluid protocol (RR 0.97, 95% CI 0.79-1.19, table 2). No differences were observed in readmission for hypertension (RR 1.04, 95% CI 0.23-4.65), cesarean delivery (RR 0.99, 95% CI 0.80-1.24), NICU admission (RR 1.07, 95% CI 0.64-1.79), or 5-minute Apgar scores (9 vs 9, p=0.65).

Conclusion:
Implementation of a restricted IV fluid labor protocol was not associated with decreased risk for intrapartum or postpartum PAH in nulliparous term pregnancies.