Lactate in fetal tissue during hypoxia; correlation to lactate, pH and base deficit in the fetal blood

E Kastendieck1, R Paulick, J Martius

  • 1Universitäts Frauenklinik Würzburg, F.R.G.

It was the aim of this study to investigate the relationship between the tissue concentrations of lactate in different organs, the blood lactate concentrations, and pH and base deficit in the extracellular fluid (BDecf) during fetal hypoxia. With regard to fetal blood analysis during labour the question is of major importance to what extent blood measurements can provide information concerning intracellular lactate concentrations, especially in the cerebral tissue. In 15 guinea-pig fetuses acute hypoxia was induced by anaesthesia, operative stress and abruption of the placenta. After puncture of the umbilical artery for blood analysis, tissue specimens were taken from the cerebral tissue, heart, liver, lung, muscle and fascia of the abdominal wall, bowel and kidney within 1 to 2 minutes and analyzed for lactate. The lactate concentrations were corrected according to the time interval from blood sampling to collection of tissue specimen. In acute hypoxia the lactate concentrations of the heart and the cerebral tissue were closely correlated to lactate, pH and base deficit measured in arterial blood. The tissue concentration of lactate in the heart and in the cerebrum exceeded the blood level approximately by 70 and 30-50%, respectively. At a pH greater than 7.10 and BDecf less than 8 mumol/ml, the lactate concentration in the cerebrum was about half the lactate concentrations leading to cerebral edema and cell necrosis in the hypoxic monkey fetus (Myers RE. In: Gluck L, ed. Intra-uterine asphyxia and the developing fetal brain. 1977, 37-97).

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