Lactate concentration in amniotic fluid at early neonatal period in perinatal hypoxia

Abstract

Aim. To determine the prognostic value of lactate concentration in amniotic fluid and umbilical cord blood of newborns at early neonatal period as indicators of increased risk of unfavorable outcome in infants with perinatal hypoxia. Methods. Determination of lactate and creatinine concentration in amniotic fluid at first stage of labor was performed by biochemical means. Determination of lactate concentration in the blood serum of infants at birth and at 3-4 days of life was also performed. Results. In timely delivery associated with perinatal hypoxia lactate concentration in amniotic fluid was increased compared to the lactate concentration in amniotic fluid during normal labor (10.6±3.18 vs 7.1±1.45 mmol/l, p 0.001). Recalculation of the lactate concentrations in amniotic fluid considering its dilution has showed a substantial difference in concentrations (0.083±0.016 vs. 0.039±0.003 mmol/l of lactate per 1 mmol/l creatinine, p 0.001). Cord blood serum lactate concentrations in newborns with perinatal hypoxia was higher compared to healthy infants (16.4±4.96 vs 9.5±3.16 mmol/l, p 0.001). Lactate concentration in umbilical cord blood serum in early neonatal period newborns rose (p 0.001), and in infants with perinatal hypoxia the increase was more significant compared to in healthy newborns (28.1±7.75 vs 13.3±3.50 mmol/l, p 0.001). Conclusion. The determination of lactate concentration in amniotic fluid at first stage of labor is an effective method to diagnose perinatal hypoxia. In early neonatal period an increase of lactate concentration in newborns, especially in newborns with perinatal hypoxia, was found.