Carbohydrate Metabolism in Fetuses with RH Alloimmunization

Abstract

Glucose, insulin, glucagon and fructosamine were measured in the plasma of control (n = 34) and of Rh fetuses (n = 22) before the first and subsequent transfusion. Prior to treatment, Rh fetuses, compared to controls, had raised concentrations of glucose (p = 0.01), glucagon (p = 0.04) and fructosamine (p = 0.004). Fetal insulin levels were not significantly different. Before subsequent transfusion, despite correction of anemia, Rh fetuses were clearly hyperinsulinemic even after correction for gestation (p = 0.002) and had low glucagon concentrations (p = 0.01) when compared with values at the first transfusion. This metabolic milieu appears similar to that of fetuses of diabetic mothers which have increased plasma glucose and insulin during most of the last third of gestation.

The effects of serial intravascular transfusions in ascitic/hydropic RhD‐alloimmunized fetuses

“…Raised triglyceride levels in growth‐restricted fetuses might indicate chronic hypoglycemia with compensatory lipolysis. The anemic fetus, however, is rather chronically hyperglycemic or normoglycemic8 and a different mechanism must therefore be postulated. Indeed, the levels of triglycerides were inversely related to fetal hematocrit at the first transfusion.…”