Arterial cord blood lactate at birth correlates with duration of pushing efforts.
OBJECTIVE
To evaluate the impact of the duration of pushing efforts on arterial cord blood lactate values.


METHODS
This was a prospective observational study of 124 consecutive normal vaginal deliveries in a tertiary teaching hospital. Arterial cord blood lactate was determined immediately at birth with a test strip method. Univariate and multivariate analyses were performed to check for clinical determinants of lactate levels. The main measure was lactate according to the duration of pushing efforts.


RESULTS
Arterial cord lactates increased significantly and were strongly correlated with the duration of pushing efforts, independent of gestational age and birthweight. Women pushing for more than 20 min had higher arterial cord blood lactates (4.9 +/- 1.4 vs. 3.3 +/- 1.16 mM, respectively) and a higher rate of lactates >6 mM (18 vs. 3%) than those pushing for less than 20 min.


CONCLUSIONS
At normal delivery, arterial cord blood lactates increase significantly with the duration of pushing efforts. Pushing for more than 20 min is associated with an increased risk of metabolic acidosis in the neonate. Further studies are required to evaluate the clinical significance of these observations.
Dessolle
Lionel
L
Department of Obstetrics, Gynecology and Reproductive Medicine, Tenon University Hospital, Paris, France.
Lebrec
Jeremie
J
Daraï
Emile
E
D000328:Adult; D000704:Analysis of Variance; D001724:Birth Weight; D036861:Delivery, Obstetric; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007749:Labor Stage, Third / Q000097:blood*; D019344:Lactic Acid / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors
D019344:Lactic Acid