Impact of maternal <scp>HIV</scp> on umbilical cord lactate measurement at delivery in a South African labor ward

Allanson, Emma; Pattinson, Robert Clive; Nathan, Elizabeth; Dickinson, Jan E.

doi:10.1002/ijgo.12477

Cited by 1 publication

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“…The maternal HIV prevalence in the post-intervention group was 23% ( n = 123), with antiretroviral therapy in 92·4% of women. A comparison of the maternal and neonatal outcomes between the HIV and non-HIV infected mothers has been published elsewhere [15].…”

Section: Resultsmentioning

confidence: 99%

A before and after study of the impact on obstetric and perinatal outcomes following the introduction of an educational package of fetal heart rate monitoring education coupled with umbilical artery lactate sampling in a low resource setting labor ward in South Africa

Allanson

Pattinson

Nathan

et al. 2019

BMC Pregnancy Childbirth

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IntroductionRates of cesarean section (CS) are increasing and abnormal fetal heart rate tracing and concern about consequent acidosis remain one of the most common indications for primary CS. Umbilical artery (UA) lactate sampling provides clinicians with point of care feedback on CTG interpretation and intrapartum care and may result in altered future practice.Materials and methodsFrom 3rd March - 12th November 2014 we undertook a before and after study in Pretoria, South Africa, to determine the impact of introducing a clinical package of fetal heart rate monitoring education and prompt feedback with UA cord lactate sampling, using a hand-held meter, on maternal and perinatal outcomes.ResultsNine hundred thirty-six consecutive samples were analyzed (pre n = 374 and post n = 562). There was no difference in mean lactate (4.6 mmol/L [95%CI 4.4–4.8] compared with 4.9 mmol/L [95%CI 4.7–5.1], p = 0.089). Suspected fetal compromise was reduced in the post-intervention period: 30·2% vs 22·1%, aOR 0·71, 95% CI 0·52–0·96, p = 0·027. Cesarean section rates were significantly reduced in the univariate analysis: pre- 40·3% vs post-intervention 31·6% (p = 0·007). This reduction remained significant when adjusted for previous cesarean section, primiparity, maternal HIV infection and preterm birth (aOR 0·72, 95%CI 0·54–0·98, p = 0·035). Neonatal outcomes did not differ between the two groups.ConclusionThe introduction of a clinical practice package of fetal heart rate monitoring education combined with routine UA cord lactate sampling has the potential to reduce the cesarean section rate without increasing adverse neonatal outcomes in a low-resource setting.

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Section: Resultsmentioning

confidence: 99%

A before and after study of the impact on obstetric and perinatal outcomes following the introduction of an educational package of fetal heart rate monitoring education coupled with umbilical artery lactate sampling in a low resource setting labor ward in South Africa

Allanson

Pattinson

Nathan

et al. 2019

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

show abstract

Impact of maternal HIV on umbilical cord lactate measurement at delivery in a South African labor ward

Abstract: Umbilical artery lactate levels and perinatal outcomes were found to be comparable between patients with and without HIV infections in a South African setting.

Cited by 1 publication

References 22 publications

A before and after study of the impact on obstetric and perinatal outcomes following the introduction of an educational package of fetal heart rate monitoring education coupled with umbilical artery lactate sampling in a low resource setting labor ward in South Africa

A before and after study of the impact on obstetric and perinatal outcomes following the introduction of an educational package of fetal heart rate monitoring education coupled with umbilical artery lactate sampling in a low resource setting labor ward in South Africa

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