Nordström L, Ingemarsson I, Kublickas M, Persson B, Shimojo N, Westgren M
Department of Obstetrics and Gynaecology, County Hospital of Ostersund, Sweden.
Br J Obstet Gynaecol. 1995 Nov;102(11):894-9. doi: 10.1111/j.1471-0528.1995.tb10878.x.
To determine fetal scalp blood lactate with a new test strip method in parturients with normal and abnormal cardiotocograms during labour and to describe the relation to maternal lactate, fetal scalp blood pH, cord artery lactate and acid-base balance.
Labour wards at the University Hospitals of Huddinge and Lund and at the County Hospital of Ostersund, Sweden.
Fetal scalp blood was sampled for lactate (n = 269) and pH (n = 285) determination in 177 parturients with abnormal intrapartum CTG. Lactate and pH were also analysed in a group of 64 women with normal pregnancies and with a reactive fetal heart rate tracing prior to sampling of fetal scalp blood. At fetal blood sampling lactate was also determined in maternal capillary blood, while at birth lactate and acid-base balance in cord artery blood was performed in almost all cases.
Medians and percentiles (lactate and acid-base balance). Correlation between fetal scalp blood lactate (dependent) and scalp blood pH, cord artery blood lactate and acid-base parameters and labour time prior to fetal blood sampling.
In the group with abnormal cardiotocograms, fetal scalp and umbilical artery blood lactate and acid-base parameters differed significantly from the same parameters in the normal group. The fetal-maternal lactate gradient changed from negative in the normal group to positive in the fetal distress group. Multiple regression analysis, with scalp lactate as the dependent parameter, revealed a significant correlation with fetal scalp blood pH (P < 0.001) and umbilical artery lactate (P < 0.01).
Intrapartum scalp blood lactate was significantly correlated with pH and cord artery lactate. The results indicate that increased lactate levels in fetal blood sampling describes fetal lactacidosis. The new disposable test strip requiring only 5 microliters of blood for lactate determination may be better than traditional methods for monitoring fetal wellbeing in labour.
采用新型试纸条法测定分娩期胎心监护正常及异常产妇的胎儿头皮血乳酸，并描述其与母体乳酸、胎儿头皮血pH值、脐动脉血乳酸及酸碱平衡的关系。
瑞典胡丁厄和隆德大学医院以及于默奥郡医院的产房。
对177例产时胎心监护异常的产妇采集胎儿头皮血测定乳酸（n = 269）和pH值（n = 285）。在另一组64例妊娠正常且在采集胎儿头皮血前胎心监护反应型的妇女中也分析了乳酸和pH值。采集胎儿血时还测定了母体毛细血管血乳酸，而几乎所有病例在出生时都检测了脐动脉血乳酸和酸碱平衡。
中位数和百分位数（乳酸及酸碱平衡）。胎儿头皮血乳酸（因变量）与头皮血pH值、脐动脉血乳酸及酸碱参数以及采集胎儿血前的产程时间之间的相关性。
在胎心监护异常组中，胎儿头皮血和脐动脉血乳酸及酸碱参数与正常组的相同参数有显著差异。胎儿 - 母体乳酸梯度从正常组的负值变为胎儿窘迫组的正值。以头皮乳酸为因变量的多元回归分析显示，其与胎儿头皮血pH值（P < 0.001）和脐动脉乳酸（P < 0.01）有显著相关性。
产时头皮血乳酸与pH值及脐动脉乳酸显著相关。结果表明，胎儿采血时乳酸水平升高提示胎儿乳酸性酸中毒。这种仅需5微升血液即可测定乳酸的新型一次性试纸条可能比传统方法更适合监测分娩期胎儿健康状况。
