Fetal response to maternal intravenous glucose load in normal and pathologic pregnancy and labor (Hebrew)

The placental passage of glucose is the main source of fetal energy, and the relationship between maternal and fetal carbohydrate metabolism has clinical implications in normal and pathological pregnancy. Placental passage of glucose was examined during delivery using a 25 g glucose load administered intravenously, and blood glucose levels were measured in the mother and fetus. In normal deliveries, the initial blood levels in mother and fetus were almost identical. After starting the load, there was a rapid rise in maternal blood sugar and a parallel rise in the fetus, in whom the peak occurred 5 min after that in the mother. In 2 cases of prolapsed cord, maternal and umbilical vein blood curves were identical. There was no delay in the timing of the peaks or difference in their heights, which confirms the complete lack of a placental barrier for glucose. In several cases of maternal diabetes, hypoglycemic levels were obtained in the fetus, and there was a definite difference in the maternal and fetal blood levels throughout the examination. Low fetal glucose levels are explained by fetal hyperinsulinism. In 5 cases of severe fetal distress, fetal hypoglycemia was found at the beginning and throughout the whole curve, which points to increased utilization of glucose during fetal distress and asphyxia.