The amniotic fluid lactate level as a possible diagnostic tool for uterine fatigue, leading to prolonged labour

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.