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Intrapartum fetal asphyxia: study of umbilical cord blood lactate in relation to fetal heart rate patterns

  • Maternal-Fetal Medicine
  • Published:
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Abstract

Purposes

To correlate between umbilical artery cord blood lactate and acid–base status with intrapartum fetal heart rate monitoring, and to measure the reliability of umbilical cord blood lactate for prediction of early neonatal outcome.

Methods

Sixty-six participants with intrapartum abnormal fetal heart rate monitoring and 60 participants with normal intrapartum recordings were recruited. The abnormal recordings included late onset, atypical variable and simple variable decelerations. After delivery, the arterial cord blood lactate, pH, actual base excess (ABE), and Apgar score were measured in all participants.

Results

There was significant inverse correlation between cord lactate and pH and ABE in all participants (correlation coefficient = −0.7, p < 0.0001). The cord lactate was significantly higher in the late onset and atypical variable decelerations groups compared to control (p < 0.0001). There was no significant correlation between the Apgar score and blood lactate in all groups; however, the sensitivity and specificity of cord lactate to predict low score at 5 min were higher in comparison to cord pH.

Conclusions

Umbilical cord blood lactate is a reliable marker for intrapartum fetal asphyxia compared to cord acid–base status with better prediction for newborns with low Apgar score.

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Acknowledgments

The author acknowledges Dr. Manal M. Kamal, MD, Physiology Department, Assiut University for her assistance in measurement of umbilical blood lactate and Dr. Maher M. Ahmad, MD, Professor of Pediatrics, Assiut University for his kind supervision to assess the neonates by staff in-charge.

Conflict of interest

The author has no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Women Health Center, Assiut University, Assiut, Egypt

    Hossam O. Hamed

  2. Department of Obstetrics and Gynecology, Qassim University, Buraidah, Saudi Arabia

    Hossam O. Hamed

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  1. Hossam O. Hamed
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Correspondence to Hossam O. Hamed.

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Hamed, H.O. Intrapartum fetal asphyxia: study of umbilical cord blood lactate in relation to fetal heart rate patterns. Arch Gynecol Obstet 287, 1067–1073 (2013). https://doi.org/10.1007/s00404-012-2694-7

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  • DOI: https://doi.org/10.1007/s00404-012-2694-7

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