Fetal lactate measurement to reduce caesarean sections during labour: a randomised trial

Conditions

None listed

Brief summary

There is currently an epidemic of caesarean sections performed in Australia and overseas. Although many caesarean sections are performed for concerns about fetal welfare, the majority of babies are shown to be well at birth, meaning that the operation, with its inherent short- and long-term risks, could have been avoided, without compromising the baby’s health. In this study, half the babies with a non-reassuring heart rate recording during labour will have a blood test to measure lactate and the other half will not. We will then determine whether having a lactate test makes a difference in the number women having caesarean births.

Christine East, Mary‐Ann Davey, C. Omar F. Kamlin, Peter G. Davis, Penelope M. Sheehan et al. (8 authors)

Australian and New Zealand Journal of Obstetrics and Gynaecology2021-03-2316 citations

10.1111/ajo.13327

Comparing the effect of STan (cardiotocographic electronic fetal monitoring (CTG) plus analysis of the ST segment of the fetal electrocardiogram) with CTG alone on emergency caesarean section rates: study protocol for the STan Australian Randomised controlled Trial (START)

Deborah Turnbull, Amy Salter, Bronni Simpson, Ben W. Mol, Edwin Chandraharan et al. (12 authors)

Trials2019-08-2911 citations

10.1186/s13063-019-3640-9

Protocol for a randomised controlled trial of fetal scalp blood lactate measurement to reduce caesarean sections during labour: the Flamingo trial [ACTRN12611000172909]

Christine East, Stefan C. Kane, Mary‐Ann Davey, C. Omar F. Kamlin, Shaun P. Brennecke et al. (6 authors)

BMC Pregnancy and Childbirth2015-11-0312 citations

10.1186/s12884-015-0709-7

Interventions

Addition of fetal blood sampling for lactate measurement during labour to standard monitoring of the fetal heart rate by cardiotocography. The initial sample will be taken following study enrollment. If non-reassuring cardiotocograph persists, repeat samples will be taken at 30-60 minute intervals until birth.

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Diagnosis

Masking

Open (masking not used)

Eligibility

Sex/Gender

All

Age

18 Years to 45 Years

Healthy volunteers

Yes

Inclusion criteria

Greater than or equal to 37 weeks gestation Labour Non-reassuring fetal heart rate pattern

Exclusion criteria

Contraindication to fetal scalp blood sampling, including known HIV and Hepatitis B or C Planned caesarean section Chorioamnionitis requiring urgent delivery Known significant fetal anomaly

Outcome results