帝王切開前に5%のデクストロースで母親の水分補給による胎児および新生児の危険性
Lancet (London, England)
|May 22, 1982
まとめ
帝王切開前の高用量デクストロース注入は,新生児に害を与え,低血糖症や黄を引き起こす可能性があります. 麻酔中に母と胎児の安全を確保するために,デクストロースを6g/hに制限します.
科学分野:
- 産婦人科と産婦人科を担当しています.
- アネステシオロジー アネステシオロジー
- ネオナトロジーの新生児科
背景:
- 低血圧は,帝王切開中の一般的な合併症です.
- 静脈内グルコース投与は,低血圧を予防するために使用されます.
- 最適なグルコース投与法は,さらなる調査が必要である.
研究 の 目的:
- 選択式帝王切開の際に,母親と新生児のアウトカムに対する異なるデクストロース療法の効果を評価する.
主な方法:
- 47人の断食中の女性を対象に,選択式帝王切開を施した予見的なランダム化研究.
- エピデュラル麻酔の前に,3つの異なる静脈内グルコースレジメンが投与されました.
- 母親の血糖,帯の血糖,インスリン,新生児の血糖およびグルカゴンレベルを測定した.
主要な成果:
- 母親の血糖値は,25gと57.5gのデクストロースの投与で有意に上昇した.
- 57.5gのデクストロース投与は胎児のグルコースとインスリンが上昇し,胎児のグルカゴンとpHが低下した.
- 新生児の低血糖症と黄の発生率の増加は,57.5gのレジメンで観察されました.
結論:
- 帝王切開前の高用量デクストロース注入 (≥25g) は胎児に有害である.
- 新生児の合併症には,低血糖症,グルカゴン放出遅延,黄の増加が含まれます.
- デクストロースの投与は,安全な割合が確立されるまで,6g/hに制限されるべきです.
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