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Lactate study using umbilical cord blood: Agreement between Lactate Pro hand‐held devices with blood gas analyser and evaluation of lactate stability over time
Author(s) -
Su Tina Y.,
Reece Mifanwy,
Chua Seng C.
Publication year - 2013
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12081
Subject(s) - umbilical cord , blood lactate , venous blood , medicine , analyser , arterial blood , arterial ph , anesthesia , surgery , chemistry , blood pressure , chromatography , heart rate , anatomy
Background Lactate measurements have become increasingly preferred over p H analysis in the evaluation of fetal acidaemia in labour. In a busy labour ward, often the umbilical cord may be sampled late and as a result yield unreliable lactate values. Aim To investigate the agreement of hand‐held device L actate P ro with a reference method blood gas analyser and evaluate the stability of umbilical cord lactate values over time. Methods Prospective study carried out at elective caesarean section. Sixteen umbilical cords were double clamped immediately after delivery with paired arterial and venous blood samples collected by an independent researcher, at varying time intervals, and processed by two L actate P ro devices and a reference method blood gas analyser. Results A significant difference of −0.41 to 0.10 mmol/L was found when different groups of L actate P ro devices were compared with blood gas analyser at lactate values up to 5.70 mmol/L, with average lactate value of 2.45 mmol/L. Over time, there is progressive rise in lactate samples obtained from the umbilical cord. Conclusion Lactate Pro devices have a significant difference, but when used in clinical practice on cord blood after delivery, this is unlikely to be meaningful. In intrapartum fetal surveillance, a systematic overestimation might lead to unnecessary intervention. It is possible to retrospectively predict the likely level of lactate at birth in delayed cord samples.