Potential hazards of hypoglycaemia in the parturient

Hypoglycaemia can cause serious problems in anaesthetized patients, due to blockade by anaesthesia of the usual compensatory mechanisms. Gravid women develop hypoglycaemia more readily than non-pregnant patients because they live in a state of "accelerated starvation." Three cases are described of healthy parturients undergoing elective Caesarean section under lumbar epidural analgesia whose post-blockade hypotension was difficult to reverse until their low blood glucose concentrations had been normalized. Further investigations of the role played by blood glucose concentrations in the maintenance of cardiovascular homeostasis in pregnant women are indicated. In the meantime, a preanaesthetic blood glucose determination will facilitate measures to ensure a normal blood glucose level before induction of anaesthesia for Caesarean section.