Wiberg-Itzel E, Pembe AB, Wray S, Wihlbäck AC, Darj E, Hoesli I, Åkerud H. Level of lactate in amniotic fluid and its relation to the use of oxytocin and adverse neonatal outcome.
Acta Obstet Gynecol Scand 2014;
93:80-5. [PMID:
24102442 DOI:
10.1111/aogs.12261]
[Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 09/06/2013] [Indexed: 11/29/2022]
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.
Collapse