Detection of fetal lactate with two-dimensional-localized proton magnetic resonance spectroscopy.
BACKGROUND
Antenatal surveillance is inefficient for accurately detecting fetal compromise. A noninvasive technique for assessing fetal metabolic status would be useful for clinical management.


METHODS
Fetal magnetic resonance spectroscopy was performed at 20 weeks in a pregnancy complicated by severe intrauterine growth restriction to determine if lactate, a metabolite associated with fetal hypoxia, was present. Two-dimensional, single-slice proton magnetic resonance spectroscopy was carried out at 1.5 T using a volume-selective, double-spin echo technique. Lactate was detected in fetal back muscle. Fetal death occurred the next day.


CONCLUSIONS
Although this initial report is purely experimental, further development of this technique may prove to be a valuable noninvasive tool in the management of suspected fetal hypoxia.
Robinson
Julian N
JN
Department of Obstetrics and Gynecology, Columbia Presbyterian Medical Center, New York, New York, USA. JNRobinson@partners.org
Cleary-Goldman
Jane
J
Arias-Mendoza
Fernando
F
Cruz-Lobo
Jaime
J
Tempany
Clare
C
Mulkern
Robert V
RV
Feinberg
Bruce B
BB
Brown
Truman R
TR
D000328:Adult; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation / Q000175:diagnosis; D005865:Gestational Age; D006801:Humans; D007773:Lactates / Q000032:analysis*; D009682:Magnetic Resonance Spectroscopy; D008661:Metabolism, Inborn Errors / Q000175:diagnosis*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D018570:Risk Assessment; D012680:Sensitivity and Specificity
D007773:Lactates