Peer-reviewed article
The amniotic fluid lactate level as a possible diagnostic tool for uterine fatigue, leading to prolonged labour.
Pospiech K, Gutowska K, Derlatka P, Koperski M, Czajkowski K ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines whether lactate levels in amniotic fluid could serve as a diagnostic marker for uterine fatigue in cases of arrested labour. Researchers measured lactate in amniotic fluid, maternal blood, and umbilical cord blood from 100 patients undergoing caesarean section. They found lactate levels were higher in arrested labour cases, suggesting amniotic fluid lactate might indicate uterine fatigue. The work proposes a potential clinical tool for identifying slow labour progression.
Key points
- Lactate levels were significantly higher in arrested labour cases compared to other groups across all compartments
- Amniotic fluid lactic acid concentration increases independently of cord blood and maternal blood lactate during labour
- Current clinical assessment of labour relies on subjective measures (vaginal examination, abdominal palpation, partogram) without objective quantifiable markers
- The study involved 100 patients divided into groups by caesarean section indications
Limitations
This is a cross-sectional case-control study using samples from patients already undergoing caesarean section, which does not establish whether lactate measurement could practically predict labour arrest before emergency intervention is needed. The study does not describe how the findings would translate into clinical decision-making or what lactate threshold would indicate intervention.
Abstract
Objectives Arrested labour is a common and dangerous complication of delivery leading to adverse outcomes for both the mother and child. Early identification of slow labour is essential for managing the condition. Currently, clinical assessment consists of vaginal examination, abdominal palpation, and the use of a partogram, but there are no well-described, objective and quantifiable markers. One possible cause of labour arrest is uterine fatigue. The aim of the study was to assess the feasibility of using lactic acid concentration in amniotic fluid as a marker of uterine fatigue contributing to labour arrest. Material and methods The trial was designed as a prospective case-control study and involved 100 patients, who underwent caesarean section (CS) divided into groups depending on indications for CS. Lactate levels were measured in amniotic fluid as well as in maternal and umbilical cord blood. Results In all compartments lactate levels were significantly higher in arrested labour cases compared to other groups. The lactic acid concentration in amniotic fluid increases independently of that in cord blood and maternal blood during ongoing labour. Conclusions Our study concludes that amniotic fluid lactate level might be reliable marker for the assessment of uterine fatigue, which may ultimately lead to labour arrest.