2011/07/13 by Ayesha M.F. Heinis, AYESHA M.F. HEINIS, Marc E. A. Spaanderman +5 · 48 citations
Medicine · #Acidosis #Anatomy #Biology #Cord blood #Endocrinology #Fetus #Internal medicine #Medicine #Metabolic acidosis #Neonatal Respiratory Health Research #Neonatal and fetal brain pathology #Obstetrics #Pregnancy #Pregnancy and preeclampsia studies #Scalp #Surgery #Umbilical artery #Umbilical cord
paper · pdf · doi:10.1111/j.1600-0412.2011.01237.x
published in Acta Obstetricia Et Gynecologica Scandinavica 90(10), 1107-1114 (Informa)
openalex publication_date 2011/07/13 · crossref created 2011/07/13 · crossref issued 2011/08/29 · crossref published 2011/08/29 · crossref published-online 2011/08/29 · crossref published-print 2011/10/01 · crossref deposited 2023/10/15 · openalex created_date 2025/10/10 · crossref indexed 2026/08/01 · openalex updated_date 2026/08/01
OBJECTIVE: To study to what extent the fetal scalp blood lactate concentration during labor correlates with fetal scalp pH and base deficit, and metabolic acidosis at birth, and to suggest lactate cut-off values to serve as indicators for either reassurance or immediate intervention. DESIGN: A retrospective observational study. SETTING: Labor ward at a university medical center. SAMPLE: Fetal scalp and cord blood samples with acid-base and lactate values from 486 singleton pregnancies beyond 34 weeks' gestation. METHODS: The relation between lactate, pH and base deficit (BD) in fetal scalp blood was tested by Spearman's rho correlation coefficient. Lactate cut-off values indicating either reassuring fetal status or immediate intervention were estimated using percentile distribution and compared with pH and BD. MAIN OUTCOME MEASURES: Metabolic acidosis, defined as umbilical cord artery pH below 7.05 and BD calculated for the blood compartment above 12 mmol/l. RESULTS: After 127 (21%) exclusions, 486 cases were available for analysis. Fetal lactate values increased with evolving metabolic acidosis. Lactate concentration correlated with both pH (r=-0.50, p<0.01) and BD (r=0.48, p<0.01). Lactate <5.4 mmol/l indicated reassuring fetal status, whereas lactate ≥6.6 mmol/l indicated metabolic acidosis. Fetal lactate correlated better with either the absence or presence of metabolic acidosis at birth than did fetal pH and BD. CONCLUSIONS: In the case of a non-reassuring fetal heart rate, fetal scalp blood lactate provides more accurate information on fetal acid-base status than does pH and/or BD.