تاثير تزريق وريدي محلول هاي حاوي گلوكز در هنگام زايمان بر وضعيت اسيد - باز نوزادان

Survey on Intravenous Fluid of Intrapartum Maternal Glucose in Acid Base of Newborns

Introduction: Acid base disorders are considered as important but preventable problems in newborns. Objective: Our purpose was to compare the effect of Intrapartum 5% glucose in the intravenous fluid on umbilical cord acid-base and glucose status after spontaneous vaginal delivery. Materials and Methods: This research is a control- case and a prospective randomized trial. To conduct this study, 200 pregnant women presenting to obstetrics & Gynecology wards of hospitals affiliated to Shiraz University of Medical Sciences were selected. These parturients were at age range of 18-39, healthy, with cervical dilatation > 4cm(active phase) and vertex presentation with normal fetal heart rate. 100 women received ringer lactate solution and 100 women ringerʹs lactate solution containing 5% glucose as maintenance Iv fluid during labor. Blood gases of neonates were compared in both groups. Results: There was a significant difference in cord PH in R/L +5% glucoses as a maintenance Iv fluid between 100 parturients of case group (7.29± 0.03) and in R1L solution in 100 parturients of control group (7.221 0.04 (p=0.00) and pco2 in RIL+5% glucose was lower than R1L group (48.7 mm Hg+ 6.1 versus 57.7 mmHg±2.3 (p=0.00) and HCO1 in RIL+5% glucose was higher than RIL group (24.8 meq/L± 1.8 versus 20.9 meq/L±2.07 (p=0.00) and base excess in first group - 4.810.7 meq/L versus- 5.711 meq/L e p=0.00). There were no statistical differences between two groups according to cord arterial glucose and neonatal glucose level and Apgar scores. Conclusion: Intrapartum intravenous fluid consisting of lactate Ringerʹs solution containing 5% glucose reduces umbilical cord acidemia and hypercarbia and base excess but increased HC03 and no change in cord level of glucose was observed. Lactated Ringerʹs solution containing 5% glucose maybe a preferable solution than solution without glucose as an intravenous fluid during labor.