Abstract
BackgroundThe level of lactate in amniotic fluid may provide useful clinical information when assessing progress of a woman’s labour and if so, a rapid, reliable method to assess amniotic fluid lactate is required in order to be clinically relevant. However, measuring lactate levels in amniotic fluid, using portable, handheld lactate meters may be less accurate than reference laboratory instruments designed to measure lactate levels in aqueous solutions. Prior to conducting a large study, we assessed recruitment, consent and sampling procedures, and the accuracy of a handheld lactate meter to measure lactate in amniotic fluid. We compared amniotic fluid lactate results obtained using the hand held Lactate Pro (Arkray) to results obtained using reference laboratory methods ABX Pentra 400 (Horiba).ResultsWe recruited 35 nulliparous women during their antenatal hospital visits and tested amniotic fluid samples collected from 20 labouring women. The handheld Lactate Pro meter was found accurate from 9–20 mmol/L with a Passing & Bablok regression of y = 0.18 + 0.97x (95% CI 0.76–1.45). Amniotic fluid lactate results remained reliable in the presence of potential contaminants commonly encountered during labour; obstetric lubricant, blood and meconium.ConclusionThe measurement of amniotic fluid lactate using the Lactate Pro meter was reliable compared to reference laboratory methods for measuring lactate levels in amniotic fluid. The pilot study enabled the refinement of information, recruitment, consenting and sampling procedures prior to commencing a large cohort study.
Highlights
The level of lactate in amniotic fluid may provide useful clinical information when assessing progress of a woman’s labour and if so, a rapid, reliable method to assess amniotic fluid lactate is required in order to be clinically relevant
A Passing & Bablok regression line fitted to the results found the Lactate Pro to be accurate from 9–20 mmol/L, with y = 0.18 + 0.97x (Figure 1)
A Passing & Bablok regression line applied to the lactate measures shows the Lactate Pro meter accurate from 9–20 mmol/ when measuring lactate in amniotic fluid collected under sterile conditions, compared to results from the reference analyser
Summary
The level of lactate in amniotic fluid may provide useful clinical information when assessing progress of a woman’s labour and if so, a rapid, reliable method to assess amniotic fluid lactate is required in order to be clinically relevant. There is a need for improved diagnostic methods and decision making tools in the diagnosis of dystocia in order to reduce the high rates of labour intervention attributable to this condition. Recent physiological studies on the effects of acidification of the uterus show human myometrium to be sensitive to changes in pH, and that accumulation of lactic acid in myometrium during contractions may reduce the strength of contractions [7,11]. More recent studies of the acid–base balance of uterine tissue indicate that MCT 4 proteins, which appear to be activated when the myometrium is hypoxic, may be the mechanism by which lactic acid in myometrium is transported to the surrounding amniotic fluid [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
