Lactate in cord blood and its relationship to pH and catecholamines in spontaneous vaginal deliveries.
The interrelationships between lactate and pH, nonadrenaline (NA), adrenaline (A) and dopamine (DA) were investigated in cord artery (CA) and vein (GV) blood at delivery. Sixty consecutive, spontaneous, vaginal deliveries with fetuses in cephalic presentation were assessed. Median gestational age at delivery was 40 weeks (range, 35-43). There were significant correlations between lactate and pH (P < 0.01), NA (P < 0.01), A (P < 0.05) and arterio-venous NA (P < 0.05) and DA differences (P < 0.01) in CA blood, while no variable correlated significantly to lactate in CV blood. The higher levels both of lactate and of catecholamines in CA blood are probably fetally derived. Dividing the material into high and low lactate subgroups (cut-off level, 75th percentile) showed a high lactate level to be associated with lower pH and higher catecholamine levels in CA blood, though the relationship was only statistically significant for pH. The levels both of catecholamines and of lactate were lower than those reported for cases of fetal distress, and reflect the lower level of fetal stress in the present series of normal deliveries. The low level of fetal stress and the differences in turnover rates between catecholamines and lactate might obscure their causal relationships, vis-a-vis fetal adaptation to extrauterine life during the course of parturition.
Department of Obstetrics and Gynaecology, County Hospital of Ostersund, Sweden.
L
L
Nordström
C
C
Marcus
B
B
Persson
N
N
Shimojo
M
M
Westgren
D036861:Delivery, Obstetric; D004298:Dopamine / Q000378:metabolism*; D004837:Epinephrine / Q000378:metabolism*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid / Q000032:analysis / Q000378:metabolism*; D009638:Norepinephrine / Q000378:metabolism*; D011247:Pregnancy; D012044:Regression Analysis; D014469:Umbilical Arteries / Q000378:metabolism; D014471:Umbilical Veins / Q000378:metabolism
D019344:Lactic Acid; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine