Influence on Fetal Carbohydrate and Fat Metabolism and on Acid-Base Balance of Glucose Administration to the Mother during Labour

Gårdmark, S.; Gennser, G.; Jacobson, L.; Rooth, Gösta; Thorell, Jan I.

doi:10.1159/000240725

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…These findings are not in agreement with those of Gardmark et al (1975) who noted rising fetal lactate concentrations with glucose infusion but could not demonstrate any significant change in fetal pH. Maternal ketonaemia was rapidly reversed but at the expense of a significant rise in lactate concentration and a significant fall in fetal pH.…”

Section: Discussioncontrasting

confidence: 98%

“…Maternal glucose administration causes a large increase in fetal plasma glucose concentration and several authors have reported isolated incidents of rapid 01 44-578618210 100/0027 $02.00 G 1982 British Journal of Obstetrics and Gynaecology fetal deterioration during glucose treatment (Paterson et al 1967: Anderson et al 1970Oakley etal. Surprisingly, two studies of the effect of glucose infusions on the acid-base status of the human fetus failed to detect major changes (Gardmark et al 1975;Feige et al 1977). Surprisingly, two studies of the effect of glucose infusions on the acid-base status of the human fetus failed to detect major changes (Gardmark et al 1975;Feige et al 1977).…”

mentioning

confidence: 99%

“…1972). Surprisingly, two studies of the effect of glucose infusions on the acid-base status of the human fetus failed to detect major changes (Gardmark et al 1975;Feige et al 1977).…”

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confidence: 99%

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

Lawrence

Brown

Parsons

et al. 1982

BJOG

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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.

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Section: Discussioncontrasting

confidence: 98%

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confidence: 99%

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

Lawrence

Brown

Parsons

et al. 1982

BJOG

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“…21 -23 During labour, in most cases, maternal plasma glucose levels rise, 19,24,25 which can be explained by the increased gluconeogenesis due to cortisol and adrenaline, produced due to a stress reaction. 26 The simultaneous rise in free fatty acids 27,28 and ketobodies 29,30 suggests, however, that a relative lack of glucose is present. Indeed, in some cases, during labour, maternal glucose concentrations decline.…”

Section: Discussionmentioning

confidence: 99%

Carbohydrate solution intake during labour just before the start of the second stage: a double‐blind study on metabolic effects and clinical outcome

Scheepers

Jong

Essed

et al. 2004

BJOG

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Objective To study the effects of oral carbohydrate ingestion on clinical outcome and on maternal and fetal metabolism. Design Prospective, double-blind, randomised study.Setting Leyenburg Hospital, The Hague, The Netherlands.Population Two hundred and two nulliparous women. MethodsIn labour, at 8 to 10 cm of cervical dilatation, the women were asked to drink a solution containing either 25 g carbohydrates or placebo. In a subgroup of 28 women, metabolic parameters were measured. Main outcome measures Number of instrumental deliveries, fetal and maternal glucose, free fatty acids, lactate, pH, Pco 2 , base excess/deficit and h-hydroxybutyrate. Results Drinking a carbohydrate-enriched solution just before starting the second stage of labour did not reduce instrumental delivery rate (RR 1.1, 95% CI 0.9-1.3). Caesarean section rate was lower in the carbohydrate group, but the difference did not reach statistical significance (1% vs 7%, RR 0.2, 95% CI 0.02 -1.2). In the carbohydrate group, maternal free fatty acids decreased and the lactate increased. In the umbilical cord there was a positive venous -arterial lactate difference in the carbohydrate group and a negative one in the placebo group, but the differences in pH and base deficit were comparable. Conclusion Intake of carbohydrates just before the second stage does not reduce instrumental delivery rate.The venous -arterial difference in the umbilical cord suggested lactate transport to the fetal circulation but did not result in fetal acidaemia.

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“…In most cases, during labor, maternal plasma glucose levels rise [3,7,9,16], which can be explained by an increased gluconeogenesis due to cortisol and adrenaline, produced due to a stress reaction. The simultaneous rise in free fatty acids and ketobodies [4,12,18,23], however, suggests that a relative lack of glucose is present. Indeed, in some cases, maternal glucose concentrations decline [3].To prevent or treat ketosis and to supplement glucose, glucose can be administered intravenously.…”

Section: Discussionmentioning

confidence: 99%