EFFECT OF ZAM ZAM WATER INTAKE DURING LABOR ON MATERNAL AND NEONATAL OUTCOME: A RANDOMIZED CONTROLLED TRIAL

Management of the oral intake of parturient seeks to provide adequate hydration and nutrition while maintaining safety for mother and baby. How to achieve this balance remains a controversial subject (Parsons, 2001).This study aimed to identify the effect of Zam Zam water intake during labor on maternal and neonatal outcomes. Design: Randomized controlled trial. Setting: This study was conducted at the birth centre in Abha general teaching hospital- Kingdom of Saudi Arabia. Sample: A total of 250 nulliparous women that attended labor and delivery rooms. The inclusion criteria were women in labor, age between 20-35 years old, in latent phase(from tip of the finger up to 3 cm cervical dilatation), at term (37 or more), with a singleton cephalic presenting fetus and free from any medical or obstetric disorders. Procedure: Women in the study group were advised to consume regular amounts of Zam Zam water of total 700 cc. and no other oral ingestion was permitted. The laboring woman received 600 cc. throughout the latent phase, started from admission and after the baseline assessment. The laboring womanreceived this amount three times, 200 cc every hour. While early in active acceleration phase (from 4-7 cm cervical dilatation), she received 100 cc of Zam Zam water in form of ice chips. Oral intake stopped when the active deceleration phase has been started (from 8-10cm cervical dilatation). Results:Mothers in the study group (Zam Zam water) had better and faster labor progress than those in the control group (plain water). In addition, by the end of labor, plasma β- hydroxybutyrate was significantly increased and plasma glucose significantly decreased in the plain water group. There was a significant statistical differences related to the umbilical arteryPH in favors of Zam Zam water. Conclusion: Zam Zam water may provide safer alternative nutritional strategy to solids in labor.