Kinetics of Lactic Acid Accumulation and Removal in the Fetus
Fetal hypoxia is one of the causes of fetal heart rate alterations, certainly the most important one clinically. Fetal hypoxia, on the other hand, is reflected by accumulation of lactic acid in the fetal body. The rise in fetal lactate concentration provides information on the hypoxic component of fetal heart rate alterations. Thus we can consider the use of the plasma lactate concentration in the fetus as a quantitative indicator of fetal hypoxia. This paper will describe the quantitative relationship between fetal lactate concentration and hypoxia. What is the hypoxic threshold for the increase in lactate concentration? How is the rise in lactate concentration related to the degree of fetal hypoxia? What is the rate of net lactate production and the maximum anaerobic metabolic rate in lactate production? Which processes remove fetal lactate in posthypoxic periods? How fast is the removal, i.e., how long does the “lactate signal” of hypoxic periods last?
KeywordsPermeability Catheter Ischemia Lactate Bicarbonate
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