Literature DB >> 24102442

Level of lactate in amniotic fluid and its relation to the use of oxytocin and adverse neonatal outcome.

Eva Wiberg-Itzel1, Andrea B Pembe, Susan Wray, Anna-Carin Wihlbäck, Elisabeth Darj, Irene Hoesli, Helena Åkerud.   

Abstract

OBJECTIVE: To assess whether the frequency of adverse neonatal outcome at delivery is related to the level of lactate in amniotic fluid and to the use of oxytocin.
DESIGN: Prospective observational study.
SETTING: Soder Hospital, Stockholm, Sweden. POPULATION: Seventy-four women in active labor with a gestational age ≥36 weeks and mixed parity.
METHODS: Levels of lactate in amniotic fluid were analyzed bedside from an intrauterine catheter every 30 min during labor. Deliveries were divided into groups with and without oxytocin. MAIN OUTCOME MEASURES: The frequency of adverse neonatal outcome at delivery. RESULT: Of the deliveries 13.5% (10/74) concluded with an adverse neonatal outcome. The levels of lactate in amniotic fluid increased during labor, more so in deliveries where oxytocin was used. In the group with an adverse neonatal outcome, the level of lactate in amniotic fluid was significantly higher in the final sample before delivery (p = 0.04). In 18 deliveries, stimulation with oxytocin was temporarily halted for at least 30 min due to overly stimulated labor contractions. A decreasing level of lactate in amniotic fluid was shown within a median 5%/30 min. In the group where the administration of oxytocin was halted, there was no adverse neonatal outcome.
CONCLUSION: The frequency of adverse neonatal outcome was associated with the level of lactate in amniotic fluid and with the use of oxytocin. The level of lactate in amniotic fluid may be an additional valuable tool when oxytocin is administered during labor.
© 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Entities:  

Keywords:  Adverse fetal outcome; amniotic fluid; anaerobe metabolism; lactate; overstimulation; oxytocin

Mesh:

Substances:

Year:  2013        PMID: 24102442     DOI: 10.1111/aogs.12261

Source DB:  PubMed          Journal:  Acta Obstet Gynecol Scand        ISSN: 0001-6349            Impact factor:   3.636


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