Association between Uterine Tachysystole during the Last Hour of Labor and Cord Blood Lactate in Parturients at Term Gestation

Arvind Palanisamy, Julia Lopez, Antonina Frolova, George Macones, Alison G. Cahill

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objective To assess whether uterine tachysystole (UT) in labor causes an increase in cord blood lactate. Study Design Secondary analysis of a prospective cohort study of all consecutive singleton gestations ≥ 37 weeks admitted for labor to a single tertiary care institution with universal cord gas policy. Patients with UT in the last hour (always) were compared with those without UT (never). Primary outcome of interest was cord blood lactate ≥ 4 mmol/L. Secondary outcomes included pH ≤ 7.10, base deficit ≥ 8 mmol/L, and admission to the neonatal intensive care unit (NICU). Multivariable logistic regression was used to estimate the risk for elevated cord blood lactate after adjusting for maternal age and body mass index. Results Of the 8,580 patients included in the analysis, 513 experienced UT 1 hour before delivery (5.9%). UT was significantly associated with elevated cord blood lactate in the always (33.5%) compared with the never group (26%) (adjusted odds ratio 1.47 [1.17, 1.86]; p < 0.01). However, there were no differences in either umbilical arterial pH, base deficit, or NICU admission rates. Conclusion UT in the last hour preceding delivery increases arterial cord blood lactate suggesting that UT proximate to delivery should be considered as a variable when interpreting cord blood gas values.

Original languageEnglish
Pages (from-to)1171-1178
Number of pages8
JournalAmerican journal of perinatology
Volume36
Issue number11
DOIs
StatePublished - Jan 1 2019

Keywords

  • cord blood lactate
  • labor
  • oxytocin
  • uterine tachysystole

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