The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2016
Fetal scalp blood lactate during second stage of labor: determination of reference values and impact of obstetrical interventions.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Wiberg Nana, Källén Karin
Аннотация
OBJECTIVE: To determine the reference interval of fetal scalp blood lactate during second stage of labor.
MATERIAL: Two hundred and fifty-three women in first stage of labor with a reassuring CTG were asked for permission to sample fetal scalp blood during second stage.
RESULTS: In cases with reassuring CTG and five minute Apgar score ≥9, the mean lactate value (±2 SD) was 2.5 mmol/L (lower limit 1.1, higher limit 5.2). The lactate concentration was significantly higher among nulliparous and in cases with use of epidural or oxytocin (p <0.001). There was a moderate positive correlation between scalp lactate values and active pushing time. When parity, epidural, oxytocin and active pushing time were analyzed together, they had equal influence on lactate values (p <0.001). Higher lactate values were associated with intermediate/pathological CTG compared to normal CTG (p <0.001). There was no correlation to gestational age or birthweight (p = 0.72, respectively 0.43).
CONCLUSIONS: The reference interval of fetal scalp lactate during second stage is 1.1-5.2 mmol/L. Parity, use of epidural or oxytocin and the duration of pushing are associated to increased lactate concentration; however, we could not demonstrate any correlation to advancing gestational age or birthweight.
MATERIAL: Two hundred and fifty-three women in first stage of labor with a reassuring CTG were asked for permission to sample fetal scalp blood during second stage.
RESULTS: In cases with reassuring CTG and five minute Apgar score ≥9, the mean lactate value (±2 SD) was 2.5 mmol/L (lower limit 1.1, higher limit 5.2). The lactate concentration was significantly higher among nulliparous and in cases with use of epidural or oxytocin (p <0.001). There was a moderate positive correlation between scalp lactate values and active pushing time. When parity, epidural, oxytocin and active pushing time were analyzed together, they had equal influence on lactate values (p <0.001). Higher lactate values were associated with intermediate/pathological CTG compared to normal CTG (p <0.001). There was no correlation to gestational age or birthweight (p = 0.72, respectively 0.43).
CONCLUSIONS: The reference interval of fetal scalp lactate during second stage is 1.1-5.2 mmol/L. Parity, use of epidural or oxytocin and the duration of pushing are associated to increased lactate concentration; however, we could not demonstrate any correlation to advancing gestational age or birthweight.