Level of lactate in amniotic fluid and its relation to the use of oxytocin and adverse neonatal outcome.

OBJECTIVE

To assess whether the frequency of adverse neonatal outcome at delivery is related to the level of lactate in amniotic fluid and to the use of oxytocin.

DESIGN

Prospective observational study.

SETTING

Soder Hospital, Stockholm, Sweden.

POPULATION

Seventy-four women in active labor with a gestational age ≥36 weeks and mixed parity.

METHODS

Levels of lactate in amniotic fluid were analyzed bedside from an intrauterine catheter every 30 min during labor. Deliveries were divided into groups with and without oxytocin.

MAIN OUTCOME MEASURES

The frequency of adverse neonatal outcome at delivery.

RESULT

Of the deliveries 13.5% (10/74) concluded with an adverse neonatal outcome. The levels of lactate in amniotic fluid increased during labor, more so in deliveries where oxytocin was used. In the group with an adverse neonatal outcome, the level of lactate in amniotic fluid was significantly higher in the final sample before delivery (p = 0.04). In 18 deliveries, stimulation with oxytocin was temporarily halted for at least 30 min due to overly stimulated labor contractions. A decreasing level of lactate in amniotic fluid was shown within a median 5%/30 min. In the group where the administration of oxytocin was halted, there was no adverse neonatal outcome.

CONCLUSION

The frequency of adverse neonatal outcome was associated with the level of lactate in amniotic fluid and with the use of oxytocin. The level of lactate in amniotic fluid may be an additional valuable tool when oxytocin is administered during labor.