H. C. J. Scheepers, P. A. de Jong, G. G. M. Essed, H. H. H. Kanhai
Fetal and maternal energy metabolism during labor in relation to the available caloric substrate
Aim: To discuss maternal and fetal metabolic events
during labor and the possible role of glucose administration.
Results: The oxidative pathway covers the largest part
of the energy demand of labor, although in the second
stage or, in polysystolic labor, the non-oxidative pathway becomes important as well. Glucose is the main
maternal energy source, but the rise in ketobodies, even
during normal labor, suggests a relative shortage. In the
first stage of labor, a combination of a respiratory alkalosis,
and to a lesser extent, a metabolic acidosis, result
in a rise in the maternal pH. In the second stage of labor,
the maternal pH decreases due to an increasing metabolic
acidosis. Glucose is also the main fetal energetic
fuel. In fetal hypoxia, lactate is produced, which in most
cases is transferred to the maternal circulation. High
maternal lactate concentrations, however, may interfere
with this process. Furthermore, fetal hyperglycemia
may lead to an increased fetal lactate production.
Conclusions: Maternal hyperglycemia, may lead to an
increase in maternal and fetal lactate production resulting
in metabolic acidosis. Unlike high dosage intravenous
glucose administration, it is not likely that oral
intake of carbohydrates leads to maternal and fetal hyperglycemia
and subsequently to metabolic acidosis, but
studies are rare.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 29, 11/2001
Pages: 457 - 464
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