Microvolume dosage of lactate in cord blood for the evaluation of the neonatal well-being
Linet, T.; Laporte, J.; Gueye, H.; Boog, G.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction 31(4): 352-357
2002
ISSN/ISBN: 0368-2315 PMID: 12058139 Document Number: 545009
A preliminary experience about a new microvolume lactate meter (Lactate Pro) is reported from 200 consecutive term deliveries. Comparison between lactate and pH in umbilical artery revealed a significant negative correlation between the two variables (r=-0.0693; p<0.0001). For the diagnosis of acidosis (pH<7.15) a lactate cutoff value at 6 mmol/l had a sensitivity of 50% and a specificity of 92% in a population with a prevalence of 8%. The study also demonstrated a better correlation between the concentrations of lactate and the base excess from 44 cord blood samples in high risk deliveries (r=0.837; p<0.0001). A lactate value higher than 6mmol/L predicted a metabolic acidosis (BE>- 8 mmol/l) with a sensitivity of 50% and a specificity of 94% from a collective with a prevalence of 16%. Considering the simplicity of the method, lactate measurements in cord blood could be extended to all birth centers for a systematic evaluation of the fetal condition in combination with the APGAR score. According to the minimal sampling volume (5 microliter) and the better prediction of metabolic acidosis this new method could replace the determination of the pH on fetal scalp.