CONTINUOUS MATERNAL GLUCOSE-INFUSION DURING LABOR - EFFECTS ON MATERNAL AND FETAL GLUCOSE AND LACTATE LEVELS

Fetal and neonatal glucose and lactate levels and acid-base balance af ter continuous maternal infusion of 5% dextrose at 180 mL/h (9 g/h) wa s compared with 0.9% saline solution in a prospective, randomized stud y from selected monitored labors. An infusion of 5% dextrose produced significantly increased glucose levels in maternal (p <0.01), cord art ery (p <0.01), and cord vein (p <0.001) blood. An increased maternal i nsulin level was also present (p <0.05), but no differences in cord in sulin levels were observed. beta-Hydroxybutyrate was lower in maternal (p <0.05) and cord vein (p <0.01), but not in cord artery blood, afte r 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), com pared with saline solution, produces higher glucose levels in both mot her and fetus, but increased insulin concentrations only in the mother . Dextrose infusion also lowers beta-hydroxybutyrate in maternal and c ord vein blood. No differences were seen in lactate levels or cord aci d-base balance. Both regimens seem safe according to risks for lactaci dosis and neonatal hypoglycemia in the normoxemic, normal size fetus.