Managing Complications in Pregnancy and Childbirth: - IAWG

C-34 Clinical use of blood, blood products and replacement fluidsthrough skin, lungs, faeces and urine. If it is anticipated that the womanwill receive IV fluids for 48 hours or more, infuse a balanced electrolytesolution (e.g. potassium chloride 1.5 g in 1 L IV fluids) with dextrose.The volume of maintenance fluids required by a woman will vary,particularly if the woman has fever or with high ambient temperature orhumidity, when losses will increase.OTHER ROUTES OF FLUID ADMINISTRATIONThere are other routes of fluid administration in addition to the IV route.ORAL AND NASOGASTRIC ADMINISTRATION• This route can often be used for women who are mildlyhypovolaemic and for women who can receive oral fluids.• Oral and nasogastric administration should not be used if:- the woman is severely hypovolaemic;- the woman is unconscious;- there are gastrointestinal lesions or reduced gut motility (e.g.obstruction);- imminent surgery with general anaesthesia is planned.RECTAL ADMINISTRATION• Rectal administration of fluids is not suitable for severelyhypovolaemic women.• Advantages of rectal administration include:- It allows the ready absorption of fluids.- Absorption ceases and fluids are ejected when hydration iscomplete.- It is administered through a plastic or rubber enema tubeinserted into the rectum and connected to a bag or bottle offluid.- The fluid rate can be controlled by using an IV set, ifnecessary.- The fluids do not have to be sterile. A safe and effectivesolution for rectal rehydration is 1 L of clean drinking water towhich a teaspoon of table salt is added.