{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T08:19:11Z","timestamp":1787991551628,"version":"build-2784847793"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"13","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>\n            Objective\u2003Maternal pushing can yield lactate levels that are above the normal range for nonpregnant individuals. Many hospitals require lactate levels as part of sepsis bundles, and this can confuse the clinicians when measured during labor. The objective of this study was to observe lactate levels in uncomplicated labor.<\/jats:p><jats:p>\n            Study Design\u2003This was a prospective study of patients presenting to Labor and Delivery in early labor. Patients met inclusion criteria if they presented at 37 weeks' gestation or greater and were either 3 to 4\u2009cm dilated, in early labor with rupture of membranes less than 12\u2009hours, or were being induced for oligohydramnios or postdates gestation. A baseline maternal lactate level was collected at enrollment. Further levels were collected at complete cervical dilation and every 30\u2009minutes during the second stage of labor up to 3\u2009hours or until delivery.<\/jats:p><jats:p>\n            Results\u2003From January 7, 2021, through December 30, 2021, a total of 148 screened patients met the inclusion criteria and 38 were enrolled. Eight (21%) patients withdrew after baseline lactate level was drawn. Twenty-three (61%) patients had a level drawn at complete dilation. Of the 12 (32%) patients with a lactate level drawn at complete and after 30\u2009minutes of pushing, the mean change in lactate level was 2.0\u2009\u00b1\u20091.8\u2009mmol\/L or 0.07\u2009\u00b1\u20090.06\u2009mmol\/L\/min (p\u2009&lt;\u20090.01). This change is more pronounced in the second stage of labor for patients with chorioamnionitis (2.6\u2009mmol\/L), although this difference is not statistically significant (p\u2009=\u20090.41).<\/jats:p><jats:p>\n            Conclusion\u2003Lactate levels increase significantly once a patient reaches complete cervical dilation within 30\u2009minutes of pushing. This increase is more pronounced, although significantly, in patients with chorioamnionitis. As sepsis is one of the leading causes of maternal morbidity and mortality, this pilot study is relevant for providers to see the natural course of lactate levels in labor.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2302-8828","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T23:20:22Z","timestamp":1712704822000},"page":"1743-1747","source":"Crossref","is-referenced-by-count":1,"title":["A Prospective Study of Lactate Levels in Uncomplicated Spontaneous and Induced Labor"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5083-4893","authenticated-orcid":false,"given":"Whitney","family":"Kleinmann","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas"},{"name":"Parkland Health, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Zofkie","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas"},{"name":"Parkland Health, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"McIntire","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas"},{"name":"Parkland Health, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4060-2685","authenticated-orcid":false,"given":"Emily H.","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas"},{"name":"Parkland Health, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.ajog.2020.07.021","article-title":"Maternal mortality in the United States: research gaps, opportunities, and priorities","volume":"223","author":"J J Chinn","year":"2020","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1097\/AOG.0000000000004361","article-title":"Maternal mortality in the United States: recent trends, current status, and future considerations","volume":"137","author":"K S Joseph","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/AOG.0000000000002114","article-title":"Pregnancy-related mortality in the United States, 2011-2013","volume":"130","author":"A A Creanga","year":"2017","journal-title":"Obstet Gynecol"},{"key":"ref4","volume-title":"Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017\u20132019","author":"S L Trost","year":"2022"},{"issue":"08","key":"ref5","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"M Singer","year":"2016","journal-title":"JAMA"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","article-title":"Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016","volume":"43","author":"A Rhodes","year":"2017","journal-title":"Intensive Care 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A model for the study of an anion-gap acidosis not associated with hyperkalemia","volume":"297","author":"C E Orringer","year":"1977","journal-title":"N Engl J Med"},{"key":"ref12","volume-title":"Physiology of Labor","author":"F Cunningham","year":"2022"},{"issue":"13","key":"ref13","doi-asserted-by":"crossref","first-page":"2150","DOI":"10.1111\/1471-0528.17264","article-title":"How should we interpret lactate in labour? A reference study","volume":"129","author":"S Dockree","year":"2022","journal-title":"BJOG"},{"issue":"09","key":"ref14","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1055\/s-0038-1675243","article-title":"Normal range for maternal lactic acid during pregnancy and labor: a systematic review and meta-analysis of observational studies","volume":"36","author":"M E Bauer","year":"2019","journal-title":"Am J Perinatol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2302-8828.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T14:55:17Z","timestamp":1730818517000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2302-8828"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,9]]},"references-count":14,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2024,9,11]]},"published-print":{"date-parts":[[2024,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2302-8828","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4,9]]},"published":{"date-parts":[[2024,4,9]]}}}