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The Solution for Dysfunctional Labor |
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 Bill & Melinda Gates Foundation supports research on the effect of the lactate concen-tration in amniotic fluid (AFL) on labor outcome, focusing on reducing maternal and infant mortality in developing countries. British BBC states:
"A test which could stop women labouring for hours in the hope of a "normal" birth only to end up with a Caesarean section has been developed in Sweden". Canadian TV highlights AFL-monitoring in an inteview with ObsteCare's CEO Johan Ubby Listen to the interview here >> |
AFL monitoring in practice
AFL (Amniotic Fluid Lactate) stands for Lactate concentration in Amniotic Fluid. Samples of amniotic fluid are collected during active labor and analyzed for the concentration of lactate. The lactate level is automatically presented in the partogram. By combining the result with the development of cervix dilatation a thorough understanding of the delivery status is obtained.
AFL measurement
Less than a few millilitre of the spontaneously pouring amniotic fluid during active labor is necessary for an accurate measurement of the AFL level. The fluid can easily be collected with a standard syringe. The fluid is delivered into the single use measuring probe on the measuring unit and the measurement starts automatically. If spontaneously pouring fluid is not available a smooth intra-uterine catheter is available for collection of the sample. AFL monitoring during Dysfunctional Labor
Substantial evidence show that a raised lactate level in the uterine muscle leads to inhibition of muscle contractions resulting in dysfunctional labor. The uterine lactate concentration is reflected in the lactate concentration in the amniotic fluid, which can be measured with a quick and non-invasive AFL (Amniotic Fluid Lactate) test.
A normal AFL level is a strong indication that using oxytocin according to normal treatment protocols will result in a spontaneous vaginal delivery.
A high AFL level is on the other hand a strong indication that using oxytocin will not improve the probability for a spontaneous vaginal delivery and that the delivery will end in operative intervention. There is also shown an association between adverse neonatal outcome at delivery, abnormal CTG and a high concentration of lactate in Amniotic Fluid.
However, if a high AFL level is appropriately taken care of during active labor, the probability for a spontaneous vaginal delivery is increased and an unnecessarily operative delivery may be avoided.
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