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Date: | Sat, 25 Oct 1997 09:33:14 -0500 |
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The indications in your hospital for blood glucose determinations are,
if you will pardon me, absurd. "Meconium stained amniotic fluid"?
Twenty percent of babies have meconium staining. Weight over 4 kg?
Why, if the mother has not had high blood sugars?
Fetal distress is too often very loosely defined. Of course, with fetal
monitoring of all pregnancies in some hospitals, we are going to find an
occasional deceleration and a reason to do a blood sugar. With IV
glucose running at anaesthesiologists rates into the mothers (at least
10 litres/hour), it is not surprising that some of the babies end up
with low sugars.
But <40 is meaningless. A dropping sugar is more important. There is a
difference between a blood sugar of 30, and 30 half an hour later, and
40 an hour later, and a blood sugar of 40 now, and 20 in a half an hour.
And colostrum keeps the glucose up much more, drop for drop than
formula. By the way, sugar water will also keep up the glucose. Why
this love of formula?
Jack Newman, MD, FRCPC
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