Lopamudra Goswami
may lead to the respiratory acidosis (pH < 7.35) and increased
lactate in the blood. Upon membrane rupture
during labour, one can measure lactate and pH levels in a
sample of blood taken from the baby’s scalp. While both
fetal scalpe lactate and pH have been previously used in
predicting adverse outcomes in labour, there is a paucity
of information on which marker is superior in this regard.
This study examines the measurement of fetal scalp
lactate superior to fetal scalp pH in predicting adverse
fetal/newborn outcomes and successful acquisition of a
usable sample among women at term in labour. Methodology
and theoretical orientation: A systematic review
of the literature was conducted using Medline, Embase,
Cochrane, and Central databases. A total of 250 articles
were included in this review. Articles were further selected
based on recency of publication as well as inclusion
and exclusion criteria. Participants included women at
term in labour. The intervention was fetal assessment
using fetal scalp lactate. The primary outcomes were apgar
scores at 5 minutes, hypoxic ischemic encephalopathy,
and admission to NICU. The secondary outcomes
included umbilical cord arterial pH <7, and umbilical
cord arterial base deficit >12. Findings: The results indicate
that there are no statistically significant differences
in Apgar scores at five minutes, admission to a NICU,
or hypoxic ischemic encephalopathy. There are also no
statistically significant differences in rates of umbilical artery
cord pH < 7 or base deficit > 12 mmol/L. There are,
however, significantly higher sampling success rates for
scalp lactate samples compared to sampling for scalp pH
testing. Conclusion and significance: These results indicate
that the measurement of fetal scalp lactate is equivalent
to fetal scalp pH for clinical decision-making to avoid
adverse neonatal outcomes. Fetal scalp lactate sampling
requires less time and is associated with fewer failed sampling
attempts. Further research is needed to determine
optimal values to indicate risk for neonatal morbidity.