Hydration and Rate of Cesarean Delivery Among Nulliparous

Inclusion Criteria

• •Nulliparous (no prior delivery after 20 weeks)
• •Presenting at ≥37 weeks of gestation
• •Presenting for anticipated induction of labor or spontaneous labor (regular contractions for more than 2 hours), but cervical dilation less than 4 cm
• •Rupture of membranes
• •Expected to deliver at one of the participating hospitals
• •Autoimmune disorders (antiphospholipid antibody, lupus, rheumatoid arthritis, scleroderma)
• •Diabetes mellitus-gestational or pre-gestational
• •Enrollment in another randomized clinical trial
• •Hematologic disorders (coagulation defects, sickle cell disease, thrombocytopenia, thrombophilia)
• •Hypertension (chronic or pregnancy induced) before randomization
• •HIV (human immunodeficiency virus)
• •Placenta previa / 3rd trimester bleeding
• •Renal insufficiency (serum creatinine \> 1.5 mg/dL)
• •Restrictive lung disease
• •Seizure disorder on medication
• •Thyroid disease on medication
• •Any contraindications to vaginal delivery (breech, active herpes, schedule cesarean, abnormal fetal heart tracing)