Routine measurements of umbilical artery lactate levels in the prediction of perinatal outcome.
OBJECTIVE
Our purpose was to compare lactate levels with acid-base balance in the umbilical artery with respect to the prediction of pregnancy outcome.


METHODS
A prospective study of 4045 cord samples was performed. Lactate was measured with a new method that requires 5 microliters of blood and provides the result within 1 minute.


RESULTS
The umbilical artery lactate concentrations were significantly elevated in instrumental deliveries (2.65 +/- 1.2 mmol/L) and in emergency cesarean sections (2.44 +/- 1.7 mmol/L) compared with spontaneous vaginal delivery (1.87 +/- 0.94 mmol/L) (p < 0.001, p < 0.001). Lactate correlated significantly to fetal pH, hemoglobin, base deficit, PCO2, and HCO3-. Lactate was comparable to pH and base deficit in sensitivity, specificity, and positive and negative predictive values in relation to morbidity and mortality.


CONCLUSIONS
Umbilical artery lactate concentration and acid-base balance predicted perinatal outcomes with similar efficacies; however, its simplicity makes lactate analysis an interesting alternative in obstetric care.
Westgren
M
M
Department of Obstetrics and Gynecology, University Hospital Huddinge, Sweden.
Divon
M
M
Horal
M
M
Ingemarsson
I
I
Kublickas
M
M
Shimojo
N
N
Nordström
L
L
D001639:Bicarbonates / Q000097:blood; D002245:Carbon Dioxide / Q000097:blood; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007773:Lactates / Q000097:blood*; D007752:Obstetric Labor, Premature / Q000097:blood; D009772:Obstetrical Forceps; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011225:Pre-Eclampsia / Q000097:blood; D011237:Predictive Value of Tests; D011247:Pregnancy / Q000097:blood*; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D014469:Umbilical Arteries
D001639:Bicarbonates; D007773:Lactates; D002245:Carbon Dioxide; D010100:Oxygen