OJOG  Vol.4 No.1 , January 2014
Accuracy of a hand-held lactate meter in measuring umbilical cord blood lactate at all lactate levels
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” (<2.2 mmol/L). Limits of agreement for lactate values (as measured by Lactate ProTM) were –1.46 - 0.97 mmol/L for arterial lactate levels <4.8 mmol/L and –3.21 - 0.88 mmol/L for 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.


Cite this paper
Chua, S. , Wong, M. , Su, T. and Reece, M. (2014) Accuracy of a hand-held lactate meter in measuring umbilical cord blood lactate at all lactate levels. Open Journal of Obstetrics and Gynecology, 4, 47-53. doi: 10.4236/ojog.2014.41009.
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