title: Routine measurements of umbilical artery lactate levels in the prediction of perinatal outcome.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Huddinge, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Westgren
authors.forename: M
authors.initials: M
authors.lastname: Divon
authors.forename: M
authors.initials: M
authors.lastname: Horal
authors.forename: I
authors.initials: I
authors.lastname: Ingemarsson
authors.forename: M
authors.initials: M
authors.lastname: Kublickas
authors.forename: N
authors.initials: N
authors.lastname: Shimojo
authors.forename: L
authors.initials: L
authors.lastname: Nordström
mesh_terms: 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
chemical_list: D001639:Bicarbonates; D007773:Lactates; D002245:Carbon Dioxide; D010100:Oxygen