Prolonged intrapartum hypoxia can result in hypoxic ischemic encephalopathy (HIE), which affects1.5-2.5 of 1,000 newborns annually. Infants with HIE may develop permanent health conditions and disorders such as cerebral palsy, epilepsy, hearing and vision impairments, and more. During labor, fetal monitoring using cardiotocography (CTG) can screen for hypoxia. CTG has high sensitivity but low predictive value, thus secondary tools are needed to aid decisions regarding intervention.

Lactate accumulates in tissues, blood and cerebral spinal fluid as a result of anaerobic metabolism due to hypoxia. Lactate levels can therefore be used to monitor hypoxia, as increased levels are associated with a high risk of compromised vital organ function. Established cut-offs for normality and acidemia for LP used worldwide were originally proposed using a POC measurement device which is no longer available. Thus, there is an urgent need to evaluate new POCT meters and assess a safe interventional cut-off for fetal acidosis.

In this webinar we will review fetal hypoxia, the clinical value of fetal scalp blood testing and the evidence for measuring lactate over pH. We will also discuss a recent study which proposes a new cutoff for scalp lactate based on neonatal outcomes with the use of the Statstrip®/StatstripXpress® Lactate system, the only POC designed for hospital use. 

Speakers:
Nana Wiberg, MD, Assoc Professor
Senior Consultant Obstetrics and Gynecology, American Hospital, Dubai, UAE and Lund University, Lund, Sweden
Linda Iorizzo, MD, PhD
Department of Clinical Sciences, Lund University