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Lactate compared with pH analysis at fetal scalp blood sampling: a prospective randomised study
1Department of Obstetrics and Gynaecology, Huddinge University Hospital, Sweden.
British Journal of Obstetrics and Gynaecology
|January 27, 1998
Summary
Fetal scalp lactate measurement is a more successful and faster alternative to pH analysis for assessing fetal well-being during labor. Both methods predict perinatal outcomes similarly, but lactate is simpler to perform.
Area of Science:
- Obstetrics and Gynecology
- Fetal Monitoring
- Intrapartum Care
Background:
- Fetal scalp blood sampling is crucial for evaluating fetal condition during abnormal heart rate patterns.
- Comparing lactate and pH analysis aids in optimizing intrapartum fetal monitoring strategies.
Purpose of the Study:
- To compare the effectiveness and efficiency of fetal scalp blood lactate versus pH management in cases of abnormal intrapartum fetal heart rate tracings.
Main Methods:
- A randomized trial involving 341 cases with ominous fetal heart rate patterns.
- 169 participants were assigned to pH analysis, and 172 to lactate measurements.
- Lactate analysis required 5 microL blood, yielding results in 60 seconds; pH analysis required 35 microL, yielding results in 47 seconds.
Main Results:
- Fetal blood sampling failures were significantly higher in the pH group (OR 16.1).
- The lactate group had fewer scalp incisions and a faster sampling procedure (median 120s vs 230s).
- No significant differences were observed in delivery mode, neonatal outcome, or umbilical artery acid-base balance.
Conclusions:
- Fetal scalp blood lactate and pH levels are comparable in predicting perinatal outcomes.
- Lactate measurement is a more successful and simpler procedure for intrapartum fetal monitoring.
- Lactate analysis presents an attractive alternative for routine intrapartum fetal assessment.