A Study of Various Factors Influencing Fetal Scalp Lactate and Their Correlation With Composite Fetal and Neonatal Outcomes

Kylie Edwards, Alka Kothari, Joel M. Dulhunty

Abstract


Background: Fetal scalp lactate has been shown to be as effective as fetal scalp pH in predicting neonatal outcomes. Maternal-fetal factors influencing variability in fetal scalp lactate have not been fully explored. This study aims to explore the association of gestational age with fetal scalp lactate and examine whether existing thresholds are predictive of adverse outcomes.

Methods: A retrospective study of all singleton births with a fetal scalp lactate taken during labor at a public teaching hospital between July 1, 2007 and June 1, 2013 was performed. Descriptive, bivariate and multivariate analysis was used to explore the association between fetal scalp lactate and other variables of interest.

Results: A total of 326 patients with fetal scalp lactate values during labor were studied. Fetal scalp lactate was not associated with gestational age (Spearman’s rho = -0.006, P = 0.92). A fetal scalp lactate >= 4.8 mmol/L was associated with maternal age (P = 0.049) and time in labor (P = 0.001). Fetal scalp lactate was strongly associated with a combined outcome variable that included emergency operative delivery (OR = 1.90; 95% CI: 1.44 - 2.51; P < 0.001). There was no significant association with a poor combined fetal and neonatal outcome when emergency intervention was excluded (OR = 1.11; 95% CI: 0.93 - 1.25; P = 0.092).

Conclusions: There was no significant correlation between fetal scalp lactate and gestational age; further exploration of the association with maternal age is warranted. A raised fetal scalp lactate is associated with progression to emergency operative delivery.




J Clin Gynecol Obstet. 2015;4(2):212-216
doi: http://dx.doi.org/10.14740/jcgo329w

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Keywords


Fetal academia; Fetal distress; Fetal scalp blood microsampling; Gestational age; labor

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