Lactate concentration in amniotic liquid and in venous blood of maternity women with dystocia
Keywords:dystocia, cesarean section, lactate, amniotic fluid, venous blood.
Objective of the study: to investigate the lactic acid value in the blood of women in labor and in the amniotic fluid and possibility of using these indicators to predict dystocia development or progression.
Material and methods. A prospective clinical and laboratory study of 136 women in labor with a single-term full-term pregnancy with cephalic presentation of fetus, without a scar on uterus was performed in the Kharkіv Сity Perinatal Center during 2018–2019. Dystocia was diagnosed in 50 women, of whom 33 gave birth by caesarean section, 17 – naturally. In 86 women dystocia was not detected, 17 of them gave birth by caesarean section for other indications, 69 – in a natural way. In addition to the standard examination, the lactate content in the amniotic fluid and in the venous blood was additionally studied by photometric method using a semi-automatic analyzer. Results are analyzed using descriptive statistics and data comparison with nonparametric methods.
Results. In women with dystocia the lactate value in the amniotic fluid is slightly higher compared to women in labor without dystocia (p >0.05), and in venous blood at the beginning of labor practically does not differ between groups. Upon repeated analysis in the blood, the concentration of lactate increased in both groups (p <0.05) with a more significant increase in women in labor with dystocia, especially in women undergoing a cesarean section.
Conclusions. Lactate value in the amniotic fluid is very variable with a tendency to increase in women with dystocia. The relative increase in lactate value in the venous blood during childbirth is most significant in women with labor by caesarean section with dystocia. A significant increase in the lactate value in the venous blood during childbirth in women with dystocia is a sign of depletion of the contractile function of the uterus and may be an additional argument in favor of cesarean section, the absence of a significant increase indicates the possibility of continued delivery in a natural way.
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