Wiberg-Itzel, E.L.C., Norman, M., Herbst, A., Prebensen, D., Hansson, A., Bryngelsson, A.L., Christoffersson, M., Sennstrom, M., Wennerholm, U.B. and Nordstrom, L. (2008) Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress: Randomised controlled multicentre trial. BMJ, 336, 1284-1287. http://dx.doi.org/10.1136/bmj.39553.406991.25

has been cited by the following article:

• TITLE: Accuracy of a hand-held lactate meter in measuring umbilical cord blood lactate at all lactate levels

  AUTHORS: Seng C. Chua, May Y. W. Wong, Tina Y. Su, Mifanwy Reece

  KEYWORDS: Agreement; Blood Gas Analyser; Comparison; Lactate; Umbilical Cord Blood

  JOURNAL NAME: Open Journal of Obstetrics and Gynecology, Vol.4 No.1, January 16, 2014

  ABSTRACT: Objective: Fetal scalp lactate has largely replaced pH analysis to assess intrapartum hypoxia. Many obstetrics units use hand-held lactate meters to measure umbilical blood because of its affordability and ease of use. We sought to investigate the agreement of Lactate ProTM with a reference method blood gas analyser and to determine its usefulness with a recommended cutoff value of 4.8 mmol/L. Methods: Prospective study carried out at a tertiary institution where 237 arterial and 233 venous samples from umbilical cords of 16 elective caesarean and 285 emergency deliveries were measured using Lactate ProTM and ABL735 Sesries Acid-Base analyser. Limits of agreement were analysed using Bland-Altman plots. Results: Lactate ProTM differentiated fewer deliveries as “high risk” (≥4.8 mmol/L) and more as “low risk” (TM) were –1.46 - 0.97 mmol/L for arterial lactate levels arterial lactate levels ≥ 4.8 mmol/L. Conclusion: There was a poorer agreement between the two devices at higher lactate values. Lactate ProTM underestimates by up to 3.2 mmol/L; a 4.8 mmol/L reading may actually signify a lactate level of 8.0 mmol/L, indicating severe metabolic acidosis. We caution the use of this device in assessing fetal lactate levels.