Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace

Abstract

Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace (Review)

FIGO consensus guidelines on intrapartum fetal monitoring: Adjunctive technologies

“…However, cut-off values for lactate need to consider the apparatus used for measurement; the 4.8 mmol/L value was the only one to have been evaluated in this manner and was established with the Lactate Pro meter (Arkray, Kyoto, Japan). Further studies should also consider subgroup analysis to establish cut-off values by gestational age and stage of labor [14]. The interpretation of pH and lactate values is shown in Table 1 [22].…”

FIGO consensus guidelines on intrapartum fetal monitoring: Adjunctive technologies

“…However, cut-off values for lactate need to consider the apparatus used for measurement; the 4.8 mmol/L value was the only one to have been evaluated in this manner and was established with the Lactate Pro meter (Arkray, Kyoto, Japan). Further studies should also consider subgroup analysis to establish cut-off values by gestational age and stage of labor [14]. The interpretation of pH and lactate values is shown in Table 1 [22].…”

Determination of Foetal Scalp Blood Sampling pH as an Indicator of Loss of Foetal Well-Being in Women Undergoing Caesarean Section

“…In addition, the physiopathological foundation supporting the use of the foetal scalp blood sample pH could be erroneous, because it is known that hypoxia at the central level causes peripheral vasoconstriction to send blood to central organs in an attempt to compensate, leading to misleading peripheral acidosis [21]. In this regard, some studies have advocated that the measurement of lactates in the scalp blood is more reliable than pH, as well as a better assessment of the metabolic aspect [16,25,33,36]. Another study found discordant results when comparing scalp pH and lactates, especially when the cervix was fully dilated and when the amniotic fluid was meconium-stained [37].…”

Proposed cut-off for fetal scalp blood lactate in intrapartum fetal surveillance based on neonatal outcomes: a prospective observational study

“…In the 90s, after valuable work with the POC measurement of lactate in scalp blood, Swedish scientists published cut-offs for normality and acidaemia for LP (6)(7)(8). These are the cut-offs recognized and used worldwide today (1,2,6). Drawbacks of that study are that the time intervals from FBS to delivery are not mentioned and that the cut-offs are partly based on the pre-existing cut-offs for pH (5,6).…”

“…The study by Haverkamp et al . was underpowered and the results from the Flamingo trial are not yet published (1,41).…”

FIGO consensus guidelines on intrapartum fetal monitoring: Adjunctive technologies

“…However, cut-off values for lactate need to consider the apparatus used for measurement; the 4.8 mmol/L value was the only one to have been evaluated in this manner and was established with the Lactate Pro meter (Arkray, Kyoto, Japan). Further studies should also consider subgroup analysis to establish cut-off values by gestational age and stage of labor [14]. The interpretation of pH and lactate values is shown in Table 1 [22].…”

Determination of Foetal Scalp Blood Sampling pH as an Indicator of Loss of Foetal Well-Being in Women Undergoing Caesarean Section

“…In addition, the physiopathological foundation supporting the use of the foetal scalp blood sample pH could be erroneous, because it is known that hypoxia at the central level causes peripheral vasoconstriction to send blood to central organs in an attempt to compensate, leading to misleading peripheral acidosis [21]. In this regard, some studies have advocated that the measurement of lactates in the scalp blood is more reliable than pH, as well as a better assessment of the metabolic aspect [16,25,33,36]. Another study found discordant results when comparing scalp pH and lactates, especially when the cervix was fully dilated and when the amniotic fluid was meconium-stained [37].…”

Proposed cut-off for fetal scalp blood lactate in intrapartum fetal surveillance based on neonatal outcomes: a prospective observational study

“…In the 90s, after valuable work with the POC measurement of lactate in scalp blood, Swedish scientists published cut-offs for normality and acidaemia for LP (6)(7)(8). These are the cut-offs recognized and used worldwide today (1,2,6). Drawbacks of that study are that the time intervals from FBS to delivery are not mentioned and that the cut-offs are partly based on the pre-existing cut-offs for pH (5,6).…”

“…The study by Haverkamp et al . was underpowered and the results from the Flamingo trial are not yet published (1,41).…”

FIGO consensus guidelines on intrapartum fetal monitoring: Adjunctive technologies

“…However, cut-off values for lactate need to consider the apparatus used for measurement; the 4.8 mmol/L value was the only one to have been evaluated in this manner and was established with the Lactate Pro meter (Arkray, Kyoto, Japan). Further studies should also consider subgroup analysis to establish cut-off values by gestational age and stage of labor [14]. The interpretation of pH and lactate values is shown in Table 1 [22].…”

Determination of Foetal Scalp Blood Sampling pH as an Indicator of Loss of Foetal Well-Being in Women Undergoing Caesarean Section

“…In addition, the physiopathological foundation supporting the use of the foetal scalp blood sample pH could be erroneous, because it is known that hypoxia at the central level causes peripheral vasoconstriction to send blood to central organs in an attempt to compensate, leading to misleading peripheral acidosis [21]. In this regard, some studies have advocated that the measurement of lactates in the scalp blood is more reliable than pH, as well as a better assessment of the metabolic aspect [16,25,33,36]. Another study found discordant results when comparing scalp pH and lactates, especially when the cervix was fully dilated and when the amniotic fluid was meconium-stained [37].…”

Proposed cut-off for fetal scalp blood lactate in intrapartum fetal surveillance based on neonatal outcomes: a prospective observational study

“…In the 90s, after valuable work with the POC measurement of lactate in scalp blood, Swedish scientists published cut-offs for normality and acidaemia for LP (6)(7)(8). These are the cut-offs recognized and used worldwide today (1,2,6). Drawbacks of that study are that the time intervals from FBS to delivery are not mentioned and that the cut-offs are partly based on the pre-existing cut-offs for pH (5,6).…”

“…The study by Haverkamp et al . was underpowered and the results from the Flamingo trial are not yet published (1,41).…”