Routine measurements of umbilical artery lactate levels the prediction of perinatal outcome

OBJECTIVE: Our purpose was to compare lactate levels with acid-base balance in the umbilical artery with respect to the prediction of pregnancy outcome. STUDY DESIGN: A prospective study of 4045 cord samples was performed. Lactate was measured with a new method that requires 5 μl of blood and provides the result within 1 minute. RESULTS: The umbilical artery lactate concentrations were significantly elevated in instrumental deliveries (2.65 ± 1.2 mmol/L) and in emergency cesarean sections (2.44 ± 1.7 mmol/L) compared with spontaneous vaginal delivery (1.87 ± 0.94 mmol/L) (p< 0.001, p< 0.001). Lactate correlated significantly to fetal pH, hemoglobin, base deficit, Pco2, and HCO3−. Lactate was comparable to pH and base deficit in sensitivity, specificity, and positive and negative predictive values in relation to morbidity and mortality. CONCLUSION: Umbilical artery lactate concentration and acid-base balance predicted perinatal outcomes with similar efficacies; however, its simplicity makes lactate analysis an interesting alternative in obstetric care.