Intrapartum foetal scalp lactate sampling for foetal assessment in the presence of a non-reassuring foetal heart rate trace

Intrapartum foetal scalp lactate sampling appears to be as effective as pH estimation for foetal assessment in the presence of a non-reassuring foetal heart rate trace. Lactate sampling appears to be more often successfully undertaken than pH estimation.

A Cochrane review included 2 studies with a total of 3348 subjects. Mother-baby pairs were allocated to either lactate or pH estimation of foetal blood samples in labour. There were no statistically significant differences for any foetal/neonatal/infant outcomes, including low Apgar score at five minutes, admission to neonatal intensive care units or neonatal encephalopathy, or for low umbilical arterial pH, base deficit or metabolic acidaemia. There was a statistically higher success rate for lactate compared with pH estimation (RR 1.10, 95% CI 1.08 to 1.12; n=2992). There were no significant between-group differences in mode of birth or operative birth for non-reassuring foetal status. No studies reported outcomes of maternal satisfaction, anxiety, length of hospital stay or economic analysis.

Comment: The quality of evidence is downgraded by study quality (unclear sequence generation in one study, no blinding ).

Ədəbiyyat

1. East CE, Leader LR, Sheehan P, Henshall NE, Colditz PB. Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace. Cochrane Database Syst Rev 2010 Mar 17;3:CD006174 [Assessed as up-to-date: 31 January 2015].