Dysfunctional labour is a major problem in obstetric care. In sports medicine, it is well known that lactate can affect muscular performance and can be decreased by bicarbonate given orally before physical activity. Amniotic fluid lactate (AFL) reflects the uterine metabolic status and high levels has been shown to associate with subsequent need for operative intervention due to dystocia. In a recently published article* dystocic primipara deliveries were randomized to an intake of bicarbonate or not. The results of the study showed that bicarbonate decreased the AFL levels (p<.001) and increased the spontaneous vaginal delivery rate (p=.007). The reduction in AFL levels was especially apparent in births with high AFL levels. These results add another tool to earlier findings that AFL can be used as a good bedside tool when treating women suffering from a dys-functional delivery.
By using AFL-monitoring in combination with Oxytocin infusion, the frequency of operative deliveries can be reduced and delivery times be optimized.
AFL was in the study 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 JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE (Eva Wiberg-Itzel, Susan Wray & Helena Åkerud (2017): A randomized controlled trial of a new treatment for labor dystocia, The Journal of Maternal-Fetal & Neonatal Medicine, DOI: 10.1080/14767058.2017.1339268).