Scalp blood lactate for intra‐partum assessment of fetal metabolic acidosis

Abstract

In the case of a non-reassuring fetal heart rate, fetal scalp blood lactate provides more accurate information on fetal acid-base status than does pH and/or BD.

Validation of a point-of-care (POC) lactate testing device for fetal scalp blood sampling during labor: clinical considerations, practicalities and realities

“…Growing evidence [8,12,13,22] is suggesting a replacement of pH levels by lactate for predicting fetal acidosis in fetal scalp blood and cord blood samples. This approach is attractive because metabolic acidosis, which is predicted more accurately by lactate than by pH, causes more long-term damage to the fetus than respiratory distress, which is indicated by decreased pH levels.…”

“…Fetal scalp pH measurement is more difficult to perform than fetal lactate testing, needs a longer collection and analyzing time and has a higher sample collection failure rate due to sample volume limitations [6,7,9,10]. Furthermore, recent studies have indicated that lactate may provide superior diagnostic reliability for early detection of fetal hypoxia than pH [11][12][13]. Furthermore, a close correlation between pH values, lactate concentrations, and neonatal outcome has been reported [6,7,10,[13][14][15][16].…”

“…Furthermore, recent studies have indicated that lactate may provide superior diagnostic reliability for early detection of fetal hypoxia than pH [11][12][13]. Furthermore, a close correlation between pH values, lactate concentrations, and neonatal outcome has been reported [6,7,10,[13][14][15][16]. Even though there are discussions on including lactate measurements into the pathway for the diagnosis of fetal distress, there are no lactate testing requirements as part of any relevant obstetrical guidelines up to date.…”

Neonatal outcome and delivery mode in labors with repetitive fetal scalp blood sampling

“…The use of FBS varies largely between countries, with reported frequencies between 3 and 15% in some countries [1,19,20], and essentially none in other. The attitude toward the use of FBS can be considered liberal at the labor ward where this study was conducted, with a frequency of 11% of all labors, but is comparable to other countries where FBS is a part of intrapartum fetal surveillance routines [19].…”

“…The attitude toward the use of FBS can be considered liberal at the labor ward where this study was conducted, with a frequency of 11% of all labors, but is comparable to other countries where FBS is a part of intrapartum fetal surveillance routines [19].…”