The effect of glucose-containing intravenous fluid administered prior to cesarean section on maternal and neonatel blood glucose levels was assessed. Twenty-one pregnant women (ASA 1), free of diabetes or any other complication who were scheduled for cesarian section were divided into two groups : the control group (N =11) and the glucose group (N =10). In both groups, 1000ml of the fluid was administered during as approximately 4-hour period, starting before operation and ending with delivery. Maternal blood before fluid therapy and maternal blood and umbilical venous blood at the time of delivery were examined for glucose, insulin and glucagon levels. Neonatal blood obtained 1, 2, 4 and 6 hours after birth was examined for glucose. Neurobehavioral examination of neonates was carried out by pediatricians. Neonatae bilirubin level was determined 5 days after birth.
1. Maternal blood glucose level at the time of delivery and umbilical venous blood glucose level were significantly higher in the glucose group (166. 2±78.9mg/dl, 135.0±65.6mg/dl) than in the controls (75.7± 14. 3mg/dl, 66. 9 ± 8. 5mg/dl).
2. Neonatal blood glucose level, 1 and 2 hours after birth was slightly lower in the glucose group than in the control group. Hypoglycemia (below 30mg/dl) was observed in 6 neonates in the glucose group, although none of these neonates showed any clinical symptom of hypoglycemia.
3. Umbilical venous blood insulin level was significantly higher in the glucose group (49.1 ± 48.1μU/ml) than in the control group (6. 3 ± 1. 3μU/ml).
4. No neurobehavioral abnormalities were noted in neonates in either group.
According to previous reports, the upper rate limit of carbohydrate administration is 20g/hour. In the present study, its administration at the rate of 12.5g/hour cause no symptoms of hypoglycemia in neonates 1 or 2 hours after birth. However, because neonates are always at a risk of developing hypoglycemia, we consider it better to avoid glucose administration unless it is indispensable. Our results also indicate the necessity of monitoring the maternal blood glucose level before belivery and checking for neonate blood glucose level and signs of hypoglycemia within 1-2 hours after birth if a glucose-containing fluid has been administered.
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