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Does Fetal Acidosis Develop With Maternal Glucose Infusion During Normal Labor?

From the Groupe de Recherche en Nutrition Foetale, Department of Physiology, Louis Pasteur University, Strasbourg; and the Department of Obstetrics and Gynecology, Centre Medico-Chirurgical et Obstetrical, Schiltigheim, France

Abstract

The actual effects of glucose infusion on fetal acid-base status were studied during 125 normal deliveries in which plasma glucose and acid-base parameters were determined after maternal infusion of either 10% glucose or Ringer's solution. After 80 minutes, mean (± SD) plasma glucose levels were significantly higher in the glucose group (N = 59) than in the Ringer's group (N = 66), both for the mother (183.6 ± 46.8 versus 95.3 ± 18.0 mg/dL) and the fetus (108.4 ± 41.4 versus 64.8 ± 16.2 mg/dL). Fetal plasma lactate concentrations did not differ between the glucose and the Ringer's groups, but were significantly lower in the fetuses delivered by elective cesarean section in both groups. With glucose administration, fetal pCO₂ was higher and pH values were lower than in the Ringer's group. However, the magnitude of acid-base status changes, indicated by both pH and pCO₂ shifts (ie, the difference between umbilical artery and scalp values), failed to differ between the two groups. In fetuses with progressing hypoxia, no differences in any of the acid-base parameters were observed between glucose and Ringer's administration. These data indicate that at a glucose infusion rate of 30 g/hour, fetal acidosis, when it occurs, results from hypoxia rather than from maternal glucose administration.