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Poster session I Clinical obstetrics, epidemiology, fetus, medical-surgical complications, neonatalogy, physiology/endocrinology, prematurity: Abstracts 87 - 236| Volume 208, ISSUE 1, SUPPLEMENT , S105-S106, January 01, 2013

230: Effect of labor on glucose concentrations in umbilical veins & arteries

      Objective

      To assess the effects of labor on fetal circulating glucose concentrations as measured in umbilical vein & artery.

      Study Design

      The study population included two groups - those who had vaginal delivery after undergoing labor (Group A,n=20) and those that underwent elective c-section (controls - Group B,n=15). Patients with medical complications (including diabetes, hypertension, systemic infections, multiple pregnancies) were excluded. Patients in both the groups received lactate ringer's solution. Maternal glucose was measured at the delivery of fetus in both the groups. Umbilical cord vessel samples were collected in heparinized syringes immediately after delivery. From that sample, glucose was analyzed using SureStep Flexx glucometer. The remaining sample was sent for cord gas evaluation using GEM Premier 4000 analyzer's iQM method.

      Results

      The two groups, A vs B, did not differ significantly in maternal age (26.4 vs 27.3 y; p=0.56), gestational age (39.5+/−0.5 vs 39.2+/−0.2, p=0.09), parity (55% vs 86% multiparous; p=0.07) or birthweight (P=0.96). Maternal glucose was comparable in both the groups (97.46+/−12.9 vs 91.38+/−13.7 mg/dl,p=0.08). Umbilical venous glucose was significantly higher in group A (90.2+/−13.5 vs 74.3+/−12.7,p=0.001). Umbilical artery glucose was also elevated in group A (77.8+/−17 vs 62.7+/−12.6, p=0.008). Umbilical vein and artery pH was similar in both the groups. Also, the umbilical vein and artery pO2 was comparable in both groups (p=0.84 & 0.72 respectively). Length of labor did not correlate with either umbilical vein or artery's glucose concentration (p= 0.82 & 0.83 respectively).

      Conclusion

      Our data indicates that labor is associated with increased umbilical vessel glucose measurements in normal pregnancies. These differences are not related to any variation in maternal glucose levels. While this increase in cord glucose concentration may be related to fetal stress in labor, cord pH and oxygen content changes (indicating significant hypoxic/acidotic stress) were not seen in the laboring patients.
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