• Lena Liljeström, Anna-Karin Wikström, Ulf Hanson, Helena Akerud, and Maria Jonsson.
• Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. lena.liljestrom@kbh.uu.se
• Acta Obstet Gynecol Scand. 2011 Oct 1; 90 (10): 1088-93.

ObjectiveTo evaluate the rate of discrepancy between pH and lactate values in fetal blood sampling (FBS). To evaluate differences in obstetric management in response to combined tests (pH and lactate) and single tests (pH or lactate).DesignDescriptive study.SettingUppsala University Hospital, Sweden.PopulationLabors monitored by FBS during one year (n=241).MethodsDiscrepancy in the combined tests was defined as a test having one abnormal and one normal value. Abnormal pH was defined as 7.24 or lower and abnormal lactate as 4.2 or higher. The results were categorized according to whether the test was normal or abnormal and according to whether it was a combined or single analysis.Main Outcome MeasuresDiscrepancy between pH and lactate values in combined tests. Frequency of operative delivery for fetal distress (ODFD). Time interval from the last FBS to ODFD.ResultsIn the combined tests with abnormality, a discrepancy between pH and lactate values occurred in 55%. The mean time interval from the last FBS to ODFD was longer in combined tests with one abnormal compared with two abnormal test results, 75 vs. 37 minutes (p<0.05). Operative delivery for fetal distress was performed less often after combined tests than after single tests: 41/62 (66%) vs. 19/20 (95%) (p<0.05).ConclusionIn the combined test, discrepancies were common and occurred in half of the samples with an abnormality. Obstetric management was influenced by the discrepancy between test results with respect to ODFD rates and the time interval from the last FBS to delivery.© 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

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