An article published in PLOS ONE (published online 26 October, 2016, doi: 10.1371/journal.pone.0161546) concludes that measuring lactate in amniotic fluid (AFL) is a good predictor of delivery outcome in arrested deliveries. Low levels of AFL may support the decision to continue a prolonged vaginal labour by augmentation with oxytocin. A high level of AFL correlates with operative interventions and post-partum complications.
The study was performed in four different countries (France, Sweden, Switzerland and Tanzania) and included 3000 delivering women. In the study, primiparous women all with a singleton pregnancy, gestational age 37 to 42 weeks and no maternal /fetal chronic and/or pregnancy-related conditions were included. A spontaneous onset of labour, regular contractions and cervical dilation ≥ 3 cm was also required.
AFL was measured using a point of care device (LMU061) from ObsteCare. The only device on the market that is regulatory approved for measuring lactate in amniotic fluid during labour. The study was part-financed by the Bill and Melinda Gates Foundation.
These findings confirm earlier findings that AFL can be used as a good bedside tool when treating women suffering from a dysfunctional delivery. By using AFL monitoring in combination with Oxytocin infusion, the frequency of operative deliveries can be reduced and delivery times be optimized.