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A new microdialysis probe for continuous lactate measurement during fetal monitoring: Proof of concept in an animal model

Tigchelaar, F., Groen, H., Westgren, M., Huinink, K. D., Cremers, T. & van den Berg, P. P., 21-Apr-2020, In : Acta Obstetricia et Gynecologica Scandinavica. 6 p.

Research output: Contribution to journalArticleAcademicpeer-review

Introduction Cardiotocography (CTG) is currently the most commonly used method for intrapartum fetal monitoring during labor. However, a high false-positive rate of fetal acidosis indicated by CTG leads to an increase in obstetric interventions. We developed a microdialysis probe that is integrated into a fetal scalp electrode allowing continuous measurement of lactate subcutaneously, thus giving instant information about the oxygenation status of the fetus. Our aim was to establish proof of concept in an animal model using a microdialysis probe to monitor lactate subcutaneously.

Material and methods We performed an in vivo study in adult male wild-type Wistar rats. We modified electrodes used for CTG monitoring in human fetuses to incorporate a microdialysis membrane. Optimum flow rates for microdialysis were determined in vitro. For the in vivo experiment, a microdialysis probe was inserted into the skin on the back of the animal. De-oxygenation and acidosis were induced by lowering the inspiratory oxygen pressure. Oxygenation and heart rate were monitored. A jugular vein cannula was inserted to draw blood samples for analysis of lactate, pH, pco(2), and saturation. Lactate levels in dialysate were compared with plasma lactate levels.

Results Baseline blood lactate levels were around 1 mmol/L. Upon de-oxygenation, oxygen saturation fell to below 40% for 1 h and blood lactate levels increased 2.5-fold. Correlation of dialysate lactate levels with plasma lactate levels was 0.89 resulting in an R-2 of .78 in the corresponding linear regression.

Conclusions In this animal model, lactate levels in subcutaneous fluid collected by microdialysis closely reflected blood lactate levels upon transient de-oxygenation, indicating that our device is suitable for subcutaneous measurement of lactate. Microdialysis probe technology allows the measurement of multiple compounds in the dialysate, such as glucose, albumin, or inflammatory mediators, so this technique may offer the unique possibility to shed light on fetal physiology during the intrapartum period.

Original languageEnglish
Number of pages6
JournalActa Obstetricia et Gynecologica Scandinavica
Early online date9-Apr-2020
Publication statusPublished - 21-Apr-2020

    Keywords

  • cardiotocography, cesarean, delivery, fetal acidosis, fetal monitoring, fetal scalp electrode, lactate, prenatal care, CLINICAL CEREBRAL MICRODIALYSIS, DIABETIC-PATIENTS, LABOR, SKIN

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