Effects Of Different Fasting Strategies Before Caesarean Section On Pregnant Women And Neonates With Gestational Diabetes Mellitus

Part Ⅰ Effects of different fasting periods before cesarean section on pregnant women and neonates with gestational diabetes mellitus:A single-center,retrospective cohort study of 2799 cases Objective:A retrospective cohort study was conducted to analyze the effects of different fasting periods before cesarean section on pregnant women with gestational diabetes mellitus(GDM)and their newborns,to explore the safe duration of fasting before cesarean section in pregnant women with gestational diabetes mellitus.Methods:A retrospective analysis of 2799 pregnant women with gestational diabetes mellitus(GDM)who underwent cesarean section in our hospital from January 2010 to October 2021.The preoperative blood glucose,hypotension in supine position during operation,nausea and vomiting,neonatal umbilical arterial blood gas p H,lactic acid,neonatal blood glucose and Apgar score were compared between different fasting and non-drinking stages.Results:There were significant differences in preoperative blood glucose,supine hypotension and nausea and vomiting among different stages(p < 0.05)There were significant differences in p H,lactic acid and neonatal blood glucose among different segments(p < 0.05),but there was no significant correlation in Apgar score among different segments.All the indexes were relatively good in the group of fasting for 6～8 hours and fasting for 2 hours.Conclusion:1.The duration of fasting before caesarean section in GDM parturients had influence on blood glucose,hypotension in supine position during operation,nausea and vomiting during operation,p H value,lactic acid value and blood glucose value of newborn umbilical artery.2.Fasting 6-8 hours before operation,fasting for 2 hours can be used as a time limit of fasting for pregnant women with gestational diabetes mellitus undergoing elective cesarean section.Part Ⅱ Effects of different oral fluids on pregnant women and neonates with gestational diabetes mellitus(GDM)before cesarean section based on ERAS: a prospective,single-center,randomized,open-label,parallel-control studyObjective:On the basis of the conclusion of the first part,the effects of different drinks on pregnant women with gestational diabetes mellitus(GDM)and their newborns were analyzed by giving them different drinks before operation,therefore,it is clear that:1.The safety of fasting for 8 hours and drinking for 2 hours before operation is better for the pregnant women with GDM.2.To provide reference for clinical practice.Methods:A total of 61 pregnant women with gestational diabetes mellitus(GDM)who underwent elective caesarean section from January 2022 to December 2022 were selected,they were randomly divided into three groups: Group D(electrolyte group,n = 21),group W(warm boiled water group,n = 21)and group K(blank traditional fasting group,n = 19).Group D and Group W were given 800 ml electrolyte drink and warm water respectively before 0 o’clock of the Operation Day,and then 200 ml electrolyte drink and warm water respectively 2 hours before operation In group K,the parturient began fasting at 0 o’clock on the Operation Day.The parturient’s thirst,hunger and anxiety were recorded before anesthesia and after operation,the vital signs and hypotension in supine position were recorded The complications,including reflux aspiration and arrhythmia,blood glucose and Apgar score at 1,5,10 minutes after birth were recorded The postoperative recovery of parturient was evaluated with Qo R-40 at 24 hours after operation.Results:The neonatal blood glucose in group D was significantly higher than that in group K(p < 0.05).The total score of Qor-40 and the score of physical comfort in Group D and Group W were higher than that in Group K,there was significant difference(p < 0.05)in the scores of other sub-items,but no significant difference(p > 0.05)in the scores of thirst,hunger and anxiety among the three groups(P >0.05)There was no significant difference in hypotension in supine position among the three groups(P > 0.05),and no serious complications such as reflux and aspiration were observed The Apgar scores at 1 min,5 min,10 min after birth in the three groups were not statistically significant(p > 0.05).Conclusion:1.On the basis of fasting for 8 hours and fasting for 2 hours,taking electrolyte drink orally 2 hours before operation has a beneficial effect on gestational diabetes mellitus(GDM)parturients and their newborns.2.Taking electrolyte drink 2 hours before cesarean section can promote the recovery of GDM parturients after operation.