Association between lactate in vaginal fluid and time to spontaneous onset of labour for women with suspected prelabour rupture of the membranes
Article first published online: 27 SEP 2006
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 113, Issue 12, pages 1426–1430, December 2006
How to Cite
Wiberg-Itzel, E., Pettersson, H., Cnattingius, S. and Nordstrom, L. (2006), Association between lactate in vaginal fluid and time to spontaneous onset of labour for women with suspected prelabour rupture of the membranes. BJOG: An International Journal of Obstetrics & Gynaecology, 113: 1426–1430. doi: 10.1111/j.1471-0528.2006.01088.x
- Issue published online: 10 NOV 2006
- Article first published online: 27 SEP 2006
- Accepted 21 August 2006. Published OnlineEarly 29 September 2006.
- Amniotic fluid;
- spontaneous onset of labour
Objectives To assess whether lactate determination in vaginal fluid is associated with, and can predict, onset of labour for women with suspected prelabour rupture of the membranes (PROM).
Design Prospective observational study.
Setting Labour ward at Soder Hospital, Stockholm, Sweden.
Population Women with suspected PROM after 34 weeks of gestation, who later had spontaneous onset of labour (n= 179).
Methods All women underwent a speculum examination and a test for determining lactate concentration in vaginal fluid. We used logistic regression to estimate the association between lactate concentration in vaginal fluid and time to onset of labour.
Main outcome measures Time from examination to onset of labour (cervix ≥4 cm), within 24 hours and 48 hours.
Results The median time interval between examination and spontaneous onset of labour was 8.4 hours for women with ‘high’ lactate (≥4.5 mmol/l) and 54 hours for those with ‘low’ lactate concentrations (<4.5 mmol/l). Among 86 women with high lactate concentrations, 76 (88%) had started labour within 24 hours compared with 20 of 93 (22%) women with low lactate concentrations (OR 27.7, 95% CI 12.2–63.3). After checking for the effect of visible amniotic fluid, the corresponding odds were still substantially increased (OR 13.5, 95% CI 5.3–34.3).
Conclusions High lactate concentration (≥4.5 mmol/l) in vaginal fluid can be used to predict whether a woman with suspected PROM will commence spontaneous onset of labour within 24 or 48 hours.