Effect of different fluid therapy regimens used sub partu on maternal and neonatal glucose and bilirubin turnover during labour and after delivery

Background: Administration of glucose 5% infusion is regularly used in obst etrics. The purpose of the study was to investigate the effects of glucose as compared to xylose and electrolyte solutions on parameters of maternal a nd fetal glucose and bilirubin metabolism during labour and after delivery. Patients and methods: 53 pregnant women (greater than or equal to 37 weeks of gestation, uncomplicated pregnancies) were randomised by entering the de livery ward. Under labour either glucose 5%, xylose 5% or electrolyte infus ions were administered. Maternal serum glucose, serum osmolarity, insulin a nd glucagon were analysed before administration and 20 minutes after delive ry. In the newborn blood osmolarity and serum glucose levels were analysed in the umbilical cord directly after birth and in capillary blood samplings 2 hours after birth. Results: Maternal blood glucose levels 20 min. post partum were significant ly different (p < 0.05). Maternal insulin and glucagon concentrations 20 mi n. pp showed similar trends with glucose levels but were not significantly different. Glucose levels in the umbilical cord were significantly higher i n the glucose than in the electrolyte group, but not higher than in the Xyl it(R) group. In contrast, the glucose-levels in the newborns after 2 h were significantly higher in the glucose group compared with both other groups. No significant differences were observed in bilirubin levels. Osmolarity i n the umbilical cord between groups differed significantly. Conclusions and Discussion: In conclusion, the administration of different solutions showed a distinct influence on the maternal and neonatal glucose metabolism. A significant impact on the bilirubin levels could not be shown in this study.