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Scalp blood lactate: a new test strip method for monitoring fetal wellbeing in labour
Author(s) -
Nordström Lennart,
Ingemarsson Ingemar,
Kublickas Marius,
Persson Bengt,
Shimojo Nobuo,
Westgren Magnus
Publication year - 1995
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1995.tb10878.x
Subject(s) - scalp , umbilical artery , umbilical cord , fetus , medicine , fetal distress , acid–base homeostasis , blood sampling , cord blood , anesthesia , surgery , pregnancy , biology , anatomy , genetics
Objective To determine fetal scalp blood lactate with a new test strip method in parturients with normal and abnormal cardiotocograms during labour and to describe the relation to maternal lactate, fetal scalp blood pH, cord artery lactate and acid‐base balance. Setting Labour wards at the University Hospitals of Huddinge and Lund and at the County Hospital of Östersund, Sweden. Materials and method Fetal scalp blood was sampled for lactate ( n = 269 ) and pH ( n = 285 ) determination in 177 parturients with abnormal intrapartum CTG. Lactate and pH were also analysed in a group of 64 women with normal pregnancies and with a reactive fetal heart rate tracing prior to sampling of fetal scalp blood. At fetal blood sampling lactate was also determined in maternal capillary blood, while at birth lactate and acid‐base balance in cord artery blood was performed in almost all cases. Main outcome measurements Medians and percentiles (lactate and acid‐base balance). Correlation between fetal scalp blood lactate (dependent) and scalp blood pH, cord artery blood lactate and acid‐base parameters and labour time prior to fetal blood sampling. Results In the group with abnormal cardiotocograms, fetal scalp and umbilical artery blood lactate and acid‐base parameters differed significantly from the same parameters in the normal group. The fetal‐maternal lactate gradient changed from negative in the normal group to positive in the fetal distress group. Multiple regression analysis, with scalp lactate as the dependent parameter, revealed a significant correlation with fetal scalp blood pH ( P < 0.001 ) and umbilical artery lactate ( P < 0.01 ). Conclusions Intrapartum scalp blood lactate was significantly correlated with pH and cord artery lactate. The results indicate that increased lactate levels in fetal blood sampling describes fetal lactacidosis. The new disposable test strip requiring only 5 μl of blood for lactate determination may be better than traditional methods for monitoring fetal wellbeing in labour.