Umbilical cord lactate compared with pH as predictors of intrapartum asphyxia

Neacsu,Adrian; Herghelegiu,Cătălin Gabriel; Voinea,Silviu; Dimitriu,Mihai Cornel Traian; Ples,Liana; Bohiltea,Roxana Elena; Braila,Anca Daniela; Nastase,Leonard; Bacalbasa,Nicolae; Chivu,Laura Ioana; Furtunescu,Florentina; Ioan,Raluca Gabriela

doi:10.3892/etm.2020.9513

Umbilical cord lactate compared with pH as predictors of intrapartum asphyxia

Authors:
- Adrian Neacsu
- Cătălin Gabriel Herghelegiu
- Silviu Voinea
- Mihai Cornel Traian Dimitriu
- Liana Ples
- Roxana Elena Bohiltea
- Anca Daniela Braila
- Leonard Nastase
- Nicolae Bacalbasa
- Laura Ioana Chivu
- Florentina Furtunescu
- Raluca Gabriela Ioan
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Affiliations: Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Surgery, Institute of Oncology ‘Prof. Dr. Alexandru Trestioreanu’, 020122 Bucharest, Romania, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania, Department of Public Health and Management, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 050463 Bucharest, Romania
Published online on: November 26, 2020 https://doi.org/10.3892/etm.2020.9513
Article Number: 80

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Abstract

Despite advances in fetal monitoring during labor, one of the most critical causes of neonatal death and neurologic injuries remains intrapartum asphyxia. Umbilical cord gases can be used to detect acidosis and fetal distress. We conducted a retrospective, multicenter study to evaluate umbilical cord blood pH and lactate as a mean of evaluating the degree of intrapartum hypoxia and also to establish which of the two is more reliable in predicting morbidity in term neonates. The present study utilized a total of 124 cases that met the criteria for intrapartum asphyxia and 150 normal term newborns that were randomly selected as case control. Both umbilical cord lactate and pH proved to be accurate predictors of neonatal morbidity caused by intrapartum hypoxia. Lactate proved to be superior to pH in predicting adverse neonatal outcome. The greatest sensibility and specificity in predicting intrapartum asphyxia were achieved in our study by using a cutoff value of 3.75 mmol/l for lactate and 7.24 for pH.

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