분만시 모체 및 태아의 혈당치에 관한 조사

Abstract

[한글]

[영문]It has been known for long the fetal blood glucose is related closely to that of mother during normal pregnancy, and the former is lower than the later. The transport of blood glucose across the placenta is directly influenced by maternal blood glucose level.

The fetal blood glucose level is influenced by endogenous and exogenous factors of the mother, and the infant born with hypoglycemia is in an unfavorable condition during the neonatal period because glucose is only source of energy to fetus. The

fetal hypoglycemia is due to 1) the rapid utilization by the fetal tissues and 2) the placental extraction of glucose.

Eastman et al (1936) described that metabolic acidosis during labor is caused by hypoxia with abnormal changes in electrolytes such as hyperkalemia, low blood pH and high pCO^^2. Paterson (1967) reported that the administration of glucose with bicarbonate improved metabolic acidosis of the newborn.

This experiment was carried out to learn the effect of 5% dextrose in water during labor on the mother and fetus. The blood glucose of the mother and fetus was evaluated in relation to the length of labor, presence of toxemia of pregnancy, protein-uria, gestation week and fetal weight.

The blood glucose from the maternal vein and umblilican vein was measured by Folin-Wu's method.

The Following results were obtained from the experiment:

1. Mean values of the maternal and the fetal blood glucose in 106 patients were 124.9 and 92.3 mg% respectively with significant difference. (p 0.001)

2. Blood glucose level of both the mother and fetus given glucose solution intravenously was significantly higher than in control group. (p 0.001, p 0.001)

3. The glucose level in the blood of the mother was not changed by the duration of labor, however, that of the fetus had a tendency to rise upto 20 hours and decreased after this time.

4. Blood glucose levels of toxemic mothers and their fetuses who were given glucose were fairly higher than the mean values of normal cases given glucose. Blood glucose level of mothers with proteinuria showed a tendency to be higher, and also was related to the degree of proteinuria in the mother. The values being

higher with increased proteinuria.

5. The maternal and fetal blood glucose levels maintained a same values by the length of gestation and birth weight.

The results suggest that the infusion of 5% dextrose in water during labor elevates the maternal blood glucose as well as fetal blood particularly in primigravid, and it can help to improve fetal condition particularly in prolonged labor.