Fetal and maternal lactate increase during active second stage of labour

摘要: Objective To determine longitudinally fetal and maternal blood lactate concentrations during the second stage of labour. Design Prospective, observational study randomly selected labours. Setting Labour ward, Sultanah Aminah General Hospital, Johore Bahru, Malaysia. Main outcome measures Fetal scalp venous lactate, umbilical arterial vein acid–base balance at delivery. Results Sixty-nine women their infants were monitored in labour. Mean by end first was 2.6 ± 1.0 (±S.D.) mmol/L increased to 3.6 ±1.4, 4.2 ±1.7, 4.8 ±1.6, 5.4 ±2.1 4.3±0.9 mmol/L, respectively, for every 15 minute bearing down. Corresponding values 2.4 ±1.1, 3.1 3.2 ±1.8, ±2.4, 4.9 ±2.8 5.8±1.9 mmol/L. The mean slope increase 0.070 per (95% CI 0.050, 0.090) 0.032 C.I.: 0.018, 0.045). duration active significantly associated with (P<0.001) (P=0.03) time crowning head, delivery (P<0.001). Expulsion ≥ 45 minutes, compared shorter stage, acidaemia birth implied larger arterial-venous differences also arterial-veonus difference (P=0.03). Conclusions Maternal labour, more rapidly mother. It is likely that anaerobic metabolism main source increase.