Feto‐maternal consequences of high‐dose glucose infusion during labour

Abstract

The effects on the fetus of high doses of glucose given to the mother in labour to correct maternal ketonuria were investigated. Three groups of patients were compared: one group received 1 litre of 10% (wiv) glucose intravenously over 1 h, the second group received 1 litre of 0.9% sodium chloride solution intravenously over 1 h and the final group had no supplementary infusion. It was observed that whereas glucose administration rapidly corrected maternal ketonaemia, there was a significant fall in p H and a rise in lactate in fetal blood. These effects were not observed in the other two groups. It was concluded that the use of high doses of intravenous glucose in labour should be avoided.

Time-dependent changes in insulin requirement for maternal glycemic control during antenatal corticosteroid therapy in women with gestational diabetes: a retrospective study

“…Steroid administration might induce maternal hyperglycemia, especially in women with gestational diabetes (GDM) or pre-existing diabetes mellitus (DM). The optimal maternal glycemic control is necessary during ACS treatment in pregnancies with GDM as well as DM because maternal hyperglycemia is associated with fetal acidosis [3,4]. Several authors have demonstrated maternal glycemic control after the corticosteTime-dependent changes in insulin requirement for maternal glycemic control during antenatal corticosteroid therapy in women with gestational diabetes: a retrospective study [5][6][7][8][9].…”

The effects of oral carbohydrate administration on fetal acid base balance

“…Indeed, in some cases, maternal glucose concentrations decline [3].To prevent or treat ketosis and to supplement glucose, glucose can be administered intravenously. When, however, high concentrations are administered, maternal and fetal hyperglycemia may occur, which, subsequently, may lead to an increase in both maternal and fetal lactate levels resulting in a metabolic acidosis [6,13,14]. In addition, hyperglycemia results in a higher fetal oxygen consumption, resulting in a higher oxygen debt, which further increases the risk of acidosis [5].…”

“…Intravenous glucose administration during labor has been associated with fetal metabolic acidosis [6,13,14,19]. Regarding the effects of eating and drinking on maternal and fetal metabolism during labor, hardly any data are available.…”

Fetal and maternal energy metabolism during labor in relation to the available caloric substrate

“…Fetal metabolic acidosis was observed after a rapid infusion of 100 g glucose per hour [28,36]. Fetal metabolic acidosis was observed after a rapid infusion of 100 g glucose per hour [28,36].…”