Hall Beverley, Wong Diana, Healy Clare, Tracy Mark B, Tracy Sally K, Rawlinson William D
Midwifery and Women's Health Research Unit, Royal Hospital for Women, Randwick, University of Sydney, Sydney, NSW, Australia.
Virology Research, Serology and Virology Division, Department of Microbiology, SEALS, Prince of Wales Hospital, Randwick, NSW, Australia.
Acta Obstet Gynecol Scand. 2017 Apr;96(4):487-495. doi: 10.1111/aogs.13089. Epub 2017 Mar 6.
Amniotic fluid lactate research is based on the hypothesis that a relationship exists between fatigued uterine muscles and raised concentrations of the metabolite lactate, which is excreted into the amniotic fluid during labor. To assess potentially confounding effects of lactate-producing organisms on amniotic fluid lactate measurements, we aimed to determine if the presence of vaginal Lactobacillus species was associated with elevated levels of amniotic fluid lactate, measured from the vaginal tract of women in labor.
Results from this study contribute to a large prospective longitudinal study of amniotic fluid lactate at a teaching hospital in Sydney, Australia. Amniotic fluid lactate measurement was assessed at the time of routine vaginal examination, after membranes had ruptured, using a hand-held lactate meter StatStripXPress (Nova Biomedical). Vaginal swab samples were collected at the time of the first amniotic fluid lactate measurement and stored for later detection and quantification of Lactobacillus species using a TaqMan real-time PCR assay. Swab sample and amniotic fluid lactate results were paired and analyzed.
The PCR assay detected Lactobacillus species in 48 of 388 (12%) vaginal swab specimens (8% positive, 4% low positive) collected from women in labor after membranes had ruptured. There was no significant difference in median and mean (respectively) amniotic fluid lactate levels with (8.35 mmol/L; 8.95 mmol/L) or without (8.5 mmol/L; 9.08 mmol/L) Lactobacillus species detected.
There was no association between the presence or level of vaginal Lactobacillus species and the measurement of amniotic fluid lactate collected from the vaginal tract of women during labor.
羊水乳酸研究基于这样一种假设，即疲劳的子宫肌肉与代谢产物乳酸浓度升高之间存在关联，乳酸在分娩过程中会排泄到羊水中。为了评估产乳酸微生物对羊水乳酸测量的潜在混杂影响，我们旨在确定分娩女性阴道中乳酸杆菌属的存在是否与羊水乳酸水平升高有关，羊水乳酸水平是从分娩女性的阴道中测量得到的。
本研究结果有助于对澳大利亚悉尼一家教学医院进行的一项关于羊水乳酸的大型前瞻性纵向研究。在胎膜破裂后的常规阴道检查时，使用手持式乳酸计StatStripXPress（诺瓦生物医学公司）评估羊水乳酸含量。在首次测量羊水乳酸时采集阴道拭子样本，并储存起来，以便日后使用TaqMan实时聚合酶链反应分析法检测和定量乳酸杆菌属。将拭子样本和羊水乳酸检测结果进行配对分析。
在胎膜破裂后收集的388份来自分娩女性的阴道拭子标本中，有48份（12%）通过聚合酶链反应分析法检测出乳酸杆菌属（8%为阳性，4%为弱阳性）。检测到乳酸杆菌属的羊水乳酸水平中位数和平均值（分别为8.35毫摩尔/升；8.95毫摩尔/升）与未检测到乳酸杆菌属的羊水乳酸水平中位数和平均值（分别为8.5毫摩尔/升；9.08毫摩尔/升）之间没有显著差异。
分娩期间女性阴道中乳酸杆菌属的存在或水平与从其阴道收集的羊水乳酸测量值之间没有关联。
