The Effect of Glucose in the Prenatal Treatment of Small-for-Date Fetuses

Abstract

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.

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

“…Glucose administration to women in labour is used in many places in ord er to augment the fetal chances of survival where there is asphyxia during birth [R om ney and G abel, 1966;Paterson et al, 1967a;P r Fbylova and Z nam en a cek , 1970; H u t e r , 1972; Sabata et al, 1973]. The metabolic conse quences for the human fetus of such a treatment are not fully known, having been studied mainly by single-point determinations of biochemical param eters in fetal blood [Paterson et al, 1967a;A n d erson et al, 1970], The opin ion has recently been expressed that glucose load to parturients may adverse ly increase the acidosis in the oxygen-deprived fetus owing to a rise of plasma lactate [Shelley, 1973].…”

Original articles

“…57% of the treated cases reaching the values of During intrapartum maternal glucose administra-normal controls, are a result of the increase in the tion fetal blood sugar levels of both AGA and SGA duration of Substrate supply duringpregnancy.The infants increase [13].Therefore,itmustbeassumed increased supply with Substrate for the fetus can that the increase in birth weight, especially in the only be one factor in the proposed mechanism of the action of prepartum glucose therapy. The increased placental weight following glucose treatment together with the birthweight is an indication for the additional effect on the function of the placenta.…”