Piquard F, Hsiung R, Schaefer A, Haberey P, Dellenbach P
Department of Physiology, Louis Pasteur University, Strasbourg, France.
Obstet Gynecol. 1989 Dec;74(6):909-14.
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.
在125例正常分娩过程中，研究了输注葡萄糖对胎儿酸碱状态的实际影响。在母体输注10%葡萄糖或林格氏液后，测定血浆葡萄糖和酸碱参数。80分钟后，葡萄糖组（N = 59）母亲和胎儿的平均（±标准差）血浆葡萄糖水平均显著高于林格氏液组（N = 66），母亲分别为（183.6±46.8对95.3±18.0mg/dL），胎儿分别为（108.4±41.4对64.8±16.2mg/dL）。葡萄糖组和林格氏液组胎儿血浆乳酸浓度无差异，但两组择期剖宫产分娩的胎儿血浆乳酸浓度均显著较低。输注葡萄糖时，胎儿的pCO2较高，pH值低于林格氏液组。然而，两组之间由pH和pCO2变化所指示的酸碱状态变化幅度（即脐动脉和头皮值之间的差异）没有差异。在进行性缺氧的胎儿中，葡萄糖输注和林格氏液输注之间的任何酸碱参数均未观察到差异。这些数据表明，以30克/小时的葡萄糖输注速率，胎儿酸中毒（如果发生）是由缺氧引起的，而非母体输注葡萄糖所致。
