Summary
10 women in labor received a drip infusion of 500 ml of 10% glucose with 16 units of crystalline insulin and further 10 received glucose infusion without insulin, about 30 min. before giving birth. In the newborn infants of these mothers was a continuous fall in the high initial blood glucose values in capillary blood, with significant decrease in ballast excess lactate, without increase in oxygen consumption. It would appear that prenatal infusion of glucose with insulin decreased partially anaerobic metabolism, without increasing the oxidative component. Such an effect might lower the tendency of the newborn to go into metabolic acidosis after birth, and assist the establishment of normal respiration.
Glucose infused to the parturient with a small-for-date fetus passes readily through the placental barrier and is retained and utilized by the fetus. The umbilical blood glucose levels are significantly increased, the arteriovenous differences show a greater retention and the FFA levels decrease. There are no signs of deterioration of fetal metabolic situation.In the small-for-date newborn the prenatal glucose infusion prevents neonatal hypoglycaemia and the enhanced FFA mobilization. Also this time metabolic changes in the newborn do not increase acidosis.The prenatal glucose infusion at a speed of 1 g glucose/min appears to be a useful tool in the treatment of small-for-date fetuses.
On the basis of investigation of certain parameters of respiratory metabolism in healthy newborn infants during the first 3 days of life [6], we concluded that blood "excess lactate", calculated by a method modified from Huckabee [l], represents a suitable criterion for the adequacy of postnatal respiratory metabolism. Similar determinations were carried out in newborn infants following complications of pregnancy or delivery and asphyxia, in order to verify the significance of blood "excess lactate".
MethodsThe methods used were those previously described 161. Determinations of lactate and pyruvate in capillary blood, oxygen consumption, blood gIucose and respiratory rate, were carried out in several groups, as well as in individual infants from birth t o 3 days of age. Chief attention was directed to blood lactate, calculated excess lactate and oxygen consumption.
ResultsIt was confirmed that the level of lactate in cord blood is dependent upon the length of labor, and the further course of blood lactate was followed in three groups of newborn infants, differing in manner of delivery and postnatal clinical condi-20 -642886 Acta Pcediatrica Vol. 53
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