TRADITIONAL FASTING CESAREAN SECTION: WHAT IS GOOD AND WHAT IS BAD?

Delivery by cesarean section can be considered as a risk factor for developing hypoglycemia in the early neonatal period, as it is preceded by a period of pre-operative fasting. One of the important components of the “fast track” concept, which is actively introduced into surgery, is “rapid metabolic optimization” aimed at reducing the period of pre-operative fasting and activating intracellular glucose transport by using combined carbohydrate-protein-glutamine drinks for the purpose of prevention of insulin resistance. The aim of the study was to determine the influence of the methods of the management in the perioperative period during abdominal delivery on the level of glucose in the blood of the puerpera and in the blood of full-term newborns Material and methods. The study was approved at the meeting of the ethical committee of the Dagestan State Medical University of the Ministry of Health of Russia on April 17, 2018. In total, in the study there were included 87 patients, whose delivery was performed in term in the Perinatal Center of the Dagestan Republican Hospital by abdominal mode and their newborns; of them, 39 patients with a common perioperative period management regimen made up a comparison group, and 48 - with abdominal delivery in the fast track strategy (with carbohydrate load) - the main group. In all puerperas the glucose level was determined in blood obtained from the vein, in the blood from the umbilical cord and in the blood taken from the newborns from the finger in the first 6 to 15 minutes of life, using the ROKI-6T biochemical analyzer. Results. The concentration of glucose in the blood of full-term newborns it was found to be significantly reduced during the management of the preoperative period without oral administration of carbohydrate mixtures. The best results were obtained in newborns whose mothers took a carbohydrate drink 2 hours prior to surgery during the perioperative period under the concept of fast track.

hypoglycemia, insulin resistance, cesarean section, perioperative period, accelerated recovery program, fast-track surgery, enteral nutrition