Significance of Lactate Levels in Vaginal Fluid with Time of Spontaneous Onset of Labour in Suspected Cases of Pre-Labour Rupture Of Membranes
Journal Title: IOSR Journal of Pharmacy and Biological Sciences (IOSR-JPBS) - Year 2017, Vol 12, Issue 3
Abstract
Background: Prelabour rupture of membranes is reported to occur in 2-25% of all pregnancies. The condition is associated with fetal and maternal infections, cord complications and might be marker of imminent delivery. It is therefore of great importance to accurately confirm the diagnosis and determine the latency period between rupture of membranes and delivery for referral of patients to higher institutions with NICU facilities and thus improve the perinatal outcome. The lactate concentration in amniotic fluid is 4-6 times higher as compared with maternal and foetal blood and hence its level in vaginal fluid can be used to establish prelabour rupture of membranes and time of spontaneous onset of labour in these patients. Objectives: 1. To diagnose prelabour rupture of membranes. 2. To establish the association between lactate levels in vaginal fluid and time of spontaneous onset of labour in cases of suspected prelabour rupture of membranes. Study Design: In this prospective observational study 108 pregnant women with singleton pregnancy of more than 34 weeks of gestation, with prelabour rupture of membranes underwent a sterile speculum examination and vaginal fluid was taken to estimate lactate level. Lactate levels were analysed in Auto analyser using spinreact kit. Then, women were followed till spontaneous onset of labour. Results: The median time of onset of spontaneous labour and examination was 12 hours in patients with lactate levels >5.0mmol/L and 72 hours in patients with lactate levels <5.0mmol/L. Among 55 women with lactate levels > 5.0mmol/L, 65.5% of women (n=36) had spontaneous onset of labour within 24 hours and 85.5% of women (n=47) within 48 hours. The odds ratio of being in labour within 24 hours is almost 18 times higher among women with lactate concentrations > 5.0mmol/L than women with lower lactate levels. Conclusion: A lactate level > 5.0mmol/L is significantly associated with the spontaneous onset of labour within 24 - 48 hours in cases of suspected prelabour rupture of membranes.
Authors and Affiliations
Prof (Dr. ) RizwanaHabib Kant1, Dr. Sabia Rashid, Dr. Mahapara, Dr. Saima Salam4, Dr. Preeti Sharma
Keywords
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- EP ID EP389337
- DOI 10.9790/3008-12030496101
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