Maternal and fetal response to rapid glucose loading in pregnancy and labor

Previous studies have demonstrated that fetal survival under conditions of asphyxia is dependent on glycogen and glucose reserves and on the ability of the fetus to utilize anaerobic glycolysis as a source of energy. The tissue level of glycogen, especially in the myocardium, is substantially diminished as a result of anoxia. Sheep and monkey fetuses which received glucose infusions survived longer periods of asphyxia, responded better to resuscitation and showed less histological cerebral damage than similar untreated animals. The latter studies resulted in attempts to treat intrauterine fetal distress in labor by maternal glucose loading. It is to be noted that in all cases in which the monitor recorded severe fetal heart rate changes, glucose loading led to almost no improvement. This may be due to the fact that the treatment did not remove the direct cause of intrauterine distress, namely hypoxia. Nevertheless, it can be assumed that the chances of fetal survival under conditions of hypoxia can be improved by raising the blood glucose level of the fetus. It is concluded therefore that it is advisable to consider treatment by i.v. glucose infusion in all cases of both acute and chronic fetal distress.