Document Detail


Fetal scalp lactate microsampling for non-reassuring fetal status during labor: a prospective observational study.
MedLine Citation:
PMID:  19940450     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim was to study the predictive value and feasibility of fetal scalp lactate microsampling in the management of non-reassuring fetal status during labor. METHODS: A prospective observational study was conducted on cord blood gas samplings from 7,617 singleton and cephalic deliveries at > or =37 weeks of gestation. In this population, 450 fetal scalp blood samples (FBS) were performed for abnormal fetal heart rate (FHR) patterns. Microvolume scalp lactate measurements were compared to scalp pH, neonatal cord blood gas parameters (pH, lactate, base deficit) and the Apgar score. RESULTS: Scalp lactate correlated significantly with scalp pH (r = -0.56, p = 0.001), umbilical artery pH (r = -0.39, p = 0.03), umbilical artery lactate (r = 0.48, p = 0.01) and umbilical artery base deficit (r = 0.51, p = 0.01), but not with Apgar scores. Using receiver operating characteristic curves, a scalp lactate cutoff value of 5 mmol/l was the most predictive for neonatal acidosis. Sampling failure with scalp lactate was inferior to scalp pH (1.3 vs. 14%, p < 0.001). CONCLUSION: Lactate microsampling in fetal scalp blood was found to be an attractive alternative to pH analysis and a useful 2nd-line tool for monitoring fetal asphyxia during labor.
Authors:
Rajeev Ramanah; Alain Martin; Marie-Caroline Clement; Robert Maillet; Didier Riethmuller
Publication Detail:
Type:  Journal Article     Date:  2009-11-25
Journal Detail:
Title:  Fetal diagnosis and therapy     Volume:  27     ISSN:  1421-9964     ISO Abbreviation:  Fetal. Diagn. Ther.     Publication Date:  2010  
Date Detail:
Created Date:  2010-01-29     Completed Date:  2010-06-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9107463     Medline TA:  Fetal Diagn Ther     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  14-9     Citation Subset:  IM    
Copyright Information:
Copyright 2009 S. Karger AG, Basel.
Affiliation:
Department of Obstetrics and Gynecology, Besan?on University Medical Center, Besan?on, France. rajeev2074@yahoo.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Asphyxia Neonatorum / diagnosis*
Female
Heart Rate, Fetal
Humans
Hydrogen-Ion Concentration
Infant, Newborn
Labor, Obstetric
Lactic Acid / blood*
Predictive Value of Tests
Pregnancy
Prospective Studies
Scalp / embryology
Chemical
Reg. No./Substance:
50-21-5/Lactic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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