{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:15:33Z","timestamp":1791249333969,"version":"4.1.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Suurvival Pluss project at Makerere University supported by NORHED\/NORAD","award":["UGA-13-0030"],"award-info":[{"award-number":["UGA-13-0030"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Oral bicarbonate solution is known to improve both maternal and perinatal outcomes among women with abnormal labour (dystocia). Its effectiveness and safety among women with obstructed labour is not known.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To determine the effect and safety of a single-dose preoperative infusion of sodium bicarbonate on maternal and fetal blood lactate and clinical outcomes among women with obstructed labour (OL) in Mbale hospital.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a double blind, randomised controlled trial from July 2018 to September 2019. The participants were women with OL at term (\u226537 weeks gestation), carrying a singleton pregnancy with no other obstetric emergency, medical comorbidity or laboratory derangements.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Intervention<\/jats:title>\n<jats:p>A total of 477 women with OL were randomized to receive 50ml of 8.4% sodium bicarbonate (238 women) or 50 mL of 0.9% sodium chloride (239 women). In both the intervention and controls arms, each participant was preoperatively given a single dose intravenous bolus. Every participant received 1.5 L of normal saline in one hour as part of standard preoperative care.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Outcome measures<\/jats:title>\n<jats:p>Our primary outcome was the mean difference in maternal venous blood lactate at one hour between the two arms. The secondary outcomes were umbilical cord blood lactate levels at birth, neonatal sepsis and early neonatal death upto 7 days postnatal, as well as the side effects of sodium bicarbonate, primary postpartum hemorrhage, maternal sepsis and mortality at 14 days postpartum.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Results<\/jats:title>\n<jats:p>The median maternal venous lactate was 6.4 (IQR 3.3\u201312.3) in the intervention and 7.5 (IQR 4.0\u201315.8) in the control group, with a statistically non-significant median difference of 1.2 mmol\/L; p-value = 0.087. Vargha and Delaney effect size was 0.46 (95% CI 0.40\u20130.51) implying very little if any effect at all.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec007\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The 4.2g of preoperative intravenous sodium bicarbonate was safe but made little or no difference on blood lactate levels.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec008\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/pactr.samrc.ac.za\/Search.aspx\" xlink:type=\"simple\">PACTR201805003364421<\/jats:ext-link>.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0245989","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T00:52:44Z","timestamp":1612918364000},"page":"e0245989","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of pre-operative bicarbonate infusion on maternal and perinatal outcomes among women with obstructed labour in Mbale hospital: A double blind randomized controlled trial"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4145-4044","authenticated-orcid":true,"given":"Milton W.","family":"Musaba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius N.","family":"Wandabwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Ndeezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Weeks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mukunya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Waako","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Nankabirwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth Tulya-muhika","family":"Mugabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Semakula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James K.","family":"Tumwine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justus K.","family":"Barageine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"key":"pone.0245989.ref001","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global causes of maternal death: A WHO systematic analysis","volume":"2","author":"L Say","year":"2014","journal-title":"Lancet Glob Heal"},{"key":"pone.0245989.ref002","author":"L Alkema","journal-title":"National, regional, and global levels and trends in maternal mortality between 1990 and 2015 with scenario-based projections to 2030: a systematic analysis by the United Nations Maternal Mortality Estimation Inter-Agency Group HHS Public Access"},{"key":"pone.0245989.ref003","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1093\/bmb\/ldg018","article-title":"Obstructed labour","volume":"67","author":"JP Neilson","year":"2003","journal-title":"Br Med Bull"},{"key":"pone.0245989.ref004","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/1471-2393-11-73","article-title":"Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda","volume":"11","author":"JK Kabakyenga","year":"2011","journal-title":"BMC Pregnancy Childbirth"},{"key":"pone.0245989.ref005","first-page":"152","article-title":"Improving the quality of obstetric care for women with obstructed labour in the national referral hospital in Uganda: lessons learnt from criteria based audit","volume":"13","author":"PK Mukasa","year":"2013","journal-title":"Reprod Health"},{"key":"pone.0245989.ref006","doi-asserted-by":"crossref","first-page":"439","DOI":"10.18203\/2320-1770.ijrcog20170027","article-title":"A study on clinical outcome of obstructed labour","volume":"6","author":"N Usharani","year":"2017","journal-title":"Int J Reprod Contracept Obs Gynecol"},{"key":"pone.0245989.ref007","unstructured":"Ministry of Health Uganda. 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