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Lactate to creatinine ratio in amniotic fluid: a pilot study
Helen L Torrance1, Lourens Pistorius, Hieronymus A M Voorbij
1Perinatal Center, University Medical Center, Utrecht, The Netherlands. H.Torrance@umcutrecht.nl
Summary
The lactate:creatinine (L:C) ratio in amniotic fluid is a more accurate indicator of fetal acidemia than lactate concentration alone. This ratio helps assess fetal well-being in complicated pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Biochemistry
Background:
- Amniotic fluid (AF) lactate concentration can indicate fetal acidemia in complicated pregnancies.
- Normalizing AF lactate by AF volume using the lactate:creatinine (L:C) ratio may improve accuracy.
Purpose of the Study:
- To compare the accuracy of AF lactate concentration and the AF L:C ratio in estimating fetal lacticaemia.
- To investigate the correlation between AF parameters and arterial cord blood lactate levels.
Main Methods:
- Measurement of AF lactate and creatinine concentrations in 38 pregnancies (28 term, 10 preterm).
- Calculation of the AF L:C ratio.
- Comparison of AF parameters with arterial cord blood lactate levels.
Main Results:
- AF lactate concentration did not correlate with cord blood lactate.
- AF L:C ratio correlated with cord blood lactate in the total population (R=0.54, p=0.001) and subgroups.
- The strongest correlation was observed in preterm intrauterine growth restricted pregnancies (n=7, R=0.83, p=0.02).
Conclusions:
- The AF L:C ratio is a more reliable marker for estimating fetal lacticaemia than AF lactate alone.
- The L:C ratio may enhance the assessment of fetal well-being in high-risk pregnancies.
