Wang Meng-Qin, Zhuang Ying, Zheng Ya-Ning
Department of Obstetrics, Nanjing Drum Tower Hospital, Nanjing, People's Republic of China.
Department of Gynecology Otolaryngology, Nanjing Drum Tower Hospital, Nanjing, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Sep 4;16:2677-2685. doi: 10.2147/DMSO.S422456. eCollection 2023.
Neonatal hypoglycemia (NH) is a common clinical symptom that can occur in both normal and critically ill neonates. The placenta is the site of material exchange between the mother and the fetus, a special organ shared by the mother and the fetus during pregnancy, and one of its important functions is to transfer nutrients from the mother to the fetus. Terbutaline is used to relax frequent uterine contractions before delivery, and it can penetrate the placental barrier and affect the normal decomposition of neonatal glycogen. The situation is neonatal hypoglycemia if not timely detection and interventions in time, the neonate may have recurrent hypoglycemia, leading to irreversible nervous system damage, such as neonatal hypoglycemic encephalopathy, and visual and cognitive impairment.
The male neonate was a single fetus, with a birth weight of 3660 g and a length of 50 cm. The blood glucose at birth was 5 mmol/L, Apgar score was 9-10, and body temperature was normal. The mother was healthy, was not diabetic, and had no other risk factors for neonatal hypoglycemia. She was injected with 0.25 mg of terbutaline 6 hours before delivery due to frequent uterine contractions. However, it was found that recurrent hypoglycemia occurred in the neonate even after adequate oral feeding.
We included evidence-based use of terbutaline 48 hours before delivery as a high-risk factor for hypoglycemia in the rooming-in neonatal hypoglycemia care program, and formulate the corresponding nursing process, with good effect.
新生儿低血糖（NH）是一种常见的临床症状，可发生于正常新生儿和危重新生儿。胎盘是母亲与胎儿之间进行物质交换的场所，是孕期母亲与胎儿共享的特殊器官，其重要功能之一是将营养物质从母亲传递给胎儿。特布他林用于在分娩前缓解频繁的子宫收缩，它可穿透胎盘屏障并影响新生儿糖原的正常分解。若不及时检测和干预，新生儿可能会反复发生低血糖，导致不可逆的神经系统损害，如新生儿低血糖脑病以及视觉和认知障碍。
该男婴为单胎，出生体重3660g，身长50cm。出生时血糖为5mmol/L，阿氏评分9 - 10分，体温正常。母亲健康，无糖尿病，无其他新生儿低血糖危险因素。因频繁子宫收缩，在分娩前6小时给她注射了0.25mg特布他林。然而，即使在充分口服喂养后，仍发现新生儿反复发生低血糖。
我们将分娩前48小时循证使用特布他林纳入母婴同室新生儿低血糖护理计划中低血糖的高危因素，并制定了相应的护理流程，效果良好。
