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Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress: randomised controlled multicentre trial

Wiberg-Itzel, E; Lipponer, C; Norman, M; Herbst, Andreas LU ; Prebensen, D; Hansson, A; Bryngelsson, A-L; Christoffersson, M; Sennstrom, M and Wennerholm, U-B, et al. (2008) In BMJ (International Edition)1988-01-01+01:002008-01-01+01:00 336(7656). p.1284-1284
Abstract
Objective To examine the effectiveness of pH analysis of fetal scalp blood compared with lactate analysis in identifying hypoxia in labour to prevent acidaemia at birth. Design Randomised controlled multicentre trial. Setting Labour wards. Participants Women with a singleton pregnancy, cephalic presentation, gestational age >= 34 weeks, and clinical indication for fetal scalp blood sampling. Interventions Standard pH analysis (n=1496) or lactate analysis (n=1496) with an electrochemical microvolume (5 mu l) test strip device. The cut-off levels for intervention were pH < 7.21 and lactate > 4.8 mmol/l, respectively. Main outcome measure Metabolic acidaemia (pH < 7.05 and base deficit > 12 mmol/l) or pH < 7.00 in cord... (More)
Objective To examine the effectiveness of pH analysis of fetal scalp blood compared with lactate analysis in identifying hypoxia in labour to prevent acidaemia at birth. Design Randomised controlled multicentre trial. Setting Labour wards. Participants Women with a singleton pregnancy, cephalic presentation, gestational age >= 34 weeks, and clinical indication for fetal scalp blood sampling. Interventions Standard pH analysis (n=1496) or lactate analysis (n=1496) with an electrochemical microvolume (5 mu l) test strip device. The cut-off levels for intervention were pH < 7.21 and lactate > 4.8 mmol/l, respectively. Main outcome measure Metabolic acidaemia (pH < 7.05 and base deficit > 12 mmol/l) or pH < 7.00 in cord artery blood. Results Metabolic acidaemia occurred in 3.2% in the lactate group and in 3.6% in the pH group (relative risk 0.91, 95% confidence interval 0.61 to 1.36). pH <7.00 occurred in 1.5% in the lactate group and in 1.8% in the pH group (0.84, 0.47 to 1.50). There was no significant difference in Apgar scores < 7 at 5 minutes (1.15, 0.76 to 1.75) or operative deliveries for fetal distress (1.02, 0.93 to 1.11). Conclusion There were no significant differences in rate of acidaemia at birth after use of lactate analysis or pH analysis of fetal scalp blood samples to determine hypoxia during labour. (Less)
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published
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BMJ (International Edition)1988-01-01+01:002008-01-01+01:00
volume
336
issue
7656
pages
1284 - 1284
publisher
BMJ Publishing Group
external identifiers
  • wos:000256705900031
  • scopus:45249084309
ISSN
0959-8146
DOI
10.1136/bmj.39553.406991.25
language
English
LU publication?
yes
id
78edd244-0a2e-45a4-b960-4ca1f60f1dd7 (old id 1201825)
date added to LUP
2008-09-16 14:38:16
date last changed
2017-05-28 03:56:23
@article{78edd244-0a2e-45a4-b960-4ca1f60f1dd7,
  abstract     = {Objective To examine the effectiveness of pH analysis of fetal scalp blood compared with lactate analysis in identifying hypoxia in labour to prevent acidaemia at birth. Design Randomised controlled multicentre trial. Setting Labour wards. Participants Women with a singleton pregnancy, cephalic presentation, gestational age &gt;= 34 weeks, and clinical indication for fetal scalp blood sampling. Interventions Standard pH analysis (n=1496) or lactate analysis (n=1496) with an electrochemical microvolume (5 mu l) test strip device. The cut-off levels for intervention were pH &lt; 7.21 and lactate &gt; 4.8 mmol/l, respectively. Main outcome measure Metabolic acidaemia (pH &lt; 7.05 and base deficit &gt; 12 mmol/l) or pH &lt; 7.00 in cord artery blood. Results Metabolic acidaemia occurred in 3.2% in the lactate group and in 3.6% in the pH group (relative risk 0.91, 95% confidence interval 0.61 to 1.36). pH &lt;7.00 occurred in 1.5% in the lactate group and in 1.8% in the pH group (0.84, 0.47 to 1.50). There was no significant difference in Apgar scores &lt; 7 at 5 minutes (1.15, 0.76 to 1.75) or operative deliveries for fetal distress (1.02, 0.93 to 1.11). Conclusion There were no significant differences in rate of acidaemia at birth after use of lactate analysis or pH analysis of fetal scalp blood samples to determine hypoxia during labour.},
  author       = {Wiberg-Itzel, E and Lipponer, C and Norman, M and Herbst, Andreas and Prebensen, D and Hansson, A and Bryngelsson, A-L and Christoffersson, M and Sennstrom, M and Wennerholm, U-B and Nordstrom, L},
  issn         = {0959-8146},
  language     = {eng},
  number       = {7656},
  pages        = {1284--1284},
  publisher    = {BMJ Publishing Group},
  series       = {	BMJ (International Edition)1988-01-01+01:002008-01-01+01:00},
  title        = {Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress: randomised controlled multicentre trial},
  url          = {http://dx.doi.org/10.1136/bmj.39553.406991.25},
  volume       = {336},
  year         = {2008},
}