Continuous Maternal Glucose Infusion During Labor: Effects on Maternal and Fetal Glucose and Lactate Levels

Lennart Nordström; S. Arulkumaran; Selina Chua; S. Ratnam; Ingemar Ingemarsson; Marius Kublickas; Bengt Persson; Nobuo Shimojo; Magnus Westgren

doi:10.1055/s-2007-994496

American Journal of Perinatology, Table of Contents

Am J Perinatol 1995; 12(5): 357-362
DOI: 10.1055/s-2007-994496

ORIGINAL ARTICLE

Continuous Maternal Glucose Infusion During Labor: Effects on Maternal and Fetal Glucose and Lactate Levels

Lennart Nordström, S. Arulkumaran, Selina Chua, S. Ratnam, Ingemar Ingemarsson, Marius Kublickas, Bengt Persson, Nobuo Shimojo, Magnus Westgren

Department of Obstetrics and Gynecology, County Hospital of Östersund, Östersund, Sweden; Department of Obstetrics and Gynecology, National University of Singapore, Singapore; Department of Obstetrics and Gynecology, University of Lund, Lund, Sweden; Department of Obstetrics and Gynecology, Huddinge University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, St. Görans Hospital, Karolinska Institutet, Stockholm, Sweden; and Department of Laboratory Medicine, Osaka University, Osaka, Japan

Abstract

ABSTRACT

Fetal and neonatal glucose and lactate levels and acid-base balance after continuous maternal infusion of 5% dextrose at 180 mL/h (9 g/h) was compared with 0.9% saline solution in a prospective, randomized study from selected monitored labors. An infusion of 5% dextrose produced significantly increased glucose levels in maternal (p < 0.01), cord artery (p < 0.01), and cord vein (p < 0.001) blood. An increased maternal insulin level was also present (p < 0.05), but no differences in cord insulin levels were observed. β-Hydroxybutyrate was lower in maternal (p < 0.05) and cord vein (p < 0.01), but not in cord artery blood, after maternal dextrose infusion. No significant changes occurred in blood lactate levels between the two groups in either mother, fetus, cord, or neonate. Acid-base balance in cord blood did not differ between the two groups. Maternal infusion of 5% dextrose at 180 mL/h (9 g/h), compared with saline solution, produces higher glucose levels in both mother and fetus, but increased insulin concentrations only in the mother. Dextrose infusion also lowers β-hydroxybutyrate in maternal and cord vein blood. No differences were seen in lactate levels or cord acid-base balance. Both regimens seem safe according to risks for lactacidosis and neonatal hypoglycemia in the normoxemic, normal size fetus.

Keywords

Pregnancy - glucose infusion - glucose - lactate - fetal acidosis

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