title: The effect of intravenous glucose solutions on neonatal blood glucose levels after cesarean delivery.
abstract: OBJECTIVE
  Intravenous solutions are often administered to the mother on the day of a cesarean delivery to minimize the effect of preoperative fasting or to stabilize the hemodynamics. Different intravenous solutions contain varying amounts of glucose, and rapid administration may lead to hypoglycemia in the neonate. We conducted a study to compare blood glucose levels of the mother and the fetus/neonate after they were rapidly given a Ringer's solution containing 0, 1, or 5 % glucose. The effect of the glucose load that these intravenous solutions impose during cesarean delivery has not been fully reported. Therefore, we compared the effect of 0 % (Group I, n = 15), 1 % (Group II, n = 15), and 5 % (Group III, n = 15) glucose acetated Ringer's solutions on maternal and umbilical blood glucose levels to determine the optimal glucose concentration.
  
  
  METHODS
  Once the patients were in the operating room, the intravenous solutions were administered before delivery. The primary endpoint was changes in umbilical blood glucose levels and minimum neonatal blood glucose levels, and the secondary endpoint was the proportion of neonates who received a glucose infusion.
  
  
  RESULTS
  Maternal blood glucose levels before and after intravenous infusion were 79.2 ± 12.2 and 74.6 ± 4.6 in Group I, 81.2 ± 12.9 and 103.3 ± 11.2 in Group II (P < 0.001), and 82.3 ± 8.7 and 252.5 ± 41.8 in Group III (P < 0.001). Umbilical blood glucose levels were 53.9 ± 10.2 in Group I, 80.8 ± 13.7 in Group II, and 181.8 ± 22.2 in Group III (P < 0.01: Group I vs. Group II and P < 0.01: Group II vs. Group III) (P < 0.001: Group I vs. Group III). Minimum neonatal blood glucose levels measured up to 8 h after birth were 35.7 ± 9.6 in Group I, 49.8 ± 10.8 in Group II, and 29.2 ± 7.5 in Group III. Neonatal hypoglycemia requiring glucose before the first milk feeding occurred in 6 neonates whose mothers were in Group I, 3 in Group II, and 9 in Group III, indicating a trend towards less neonatal hypoglycemia in Group II.
  
  
  CONCLUSIONS
  The use of 1 % glucose acetated Ringer's solution did not induce hyperglycemia in the mother and it was able to maintain appropriate blood glucose levels in the fetus.
authors.affiliation: Department of Anesthesiology, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose, Tokyo 204-8585, Japan. a6m3_hamp@me.com
authors.forename: Isao
authors.initials: I
authors.lastname: Fukuda
authors.forename: Hideo
authors.initials: H
authors.lastname: Matsuda
authors.forename: Shinya
authors.initials: S
authors.lastname: Sugahara
authors.forename: Tomiei
authors.initials: T
authors.lastname: Kazama
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000773:Anesthesia, Obstetrical; D001786:Blood Glucose / Q000378:metabolism; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005333:Fetus / Q000378:metabolism; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007552:Isotonic Solutions; D011247:Pregnancy; D000077331:Ringer's Solution; D012996:Solutions
chemical_list: D001786:Blood Glucose; D007552:Isotonic Solutions; D012996:Solutions; D000077331:Ringer's Solution; D005947:Glucose