title: Fetal scalp and cord blood lactate.
abstract: Lactate measurements have been evaluated in intrapartum fetal surveillance for some 30 years. However, it was not until reliable, handheld, microvolume devices were launched during the 1990s that lactate became a clinical option. Retrospective data suggest that lactate determinations in fetal scalp blood are better than pH for predicting severe neonatal morbidity. A randomised controlled trial comparing these two measurements found lactate to be more favourable in clinical practice in terms of less sampling failure and reduced time from the decision to do a fetal scalp blood sample to the clinician receiving the result. At present, a large multicenter randomised control trial is in progress in Sweden to compare lactate and pH measurement for the clinical management of suspected fetal compromise. Main end-points in the study are metabolic acidemia or pH <7.00 in cord arterial blood at delivery. Results are likely to be available in 2-3 years time.
authors.affiliation: Karolinska University Hospital, Solna, 17176 Stockholm, Sweden. lennart.nordstrom@kus.se
authors.forename: Lennart
authors.initials: L
authors.lastname: Nordström
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D001800:Blood Specimen Collection / Q000379:methods; D005312:Fetal Blood / Q000737:chemistry*; D005316:Fetal Distress / Q000175:diagnosis*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid / Q000097:blood*; D012535:Scalp / Q000098:blood supply*
chemical_list: D015415:Biomarkers; D019344:Lactic Acid