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

Authors
  • Tigchelaar, Froukje1
  • Groen, Henk2
  • Westgren, Magnus3
  • Huinink, Kirsten D4
  • Cremers, Thomas5, 6
  • van den Berg, Paul P7
  • 1 Faculty of Medical Sciences, University of Groningen, Groningen, the Netherlands. , (Netherlands)
  • 2 Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. , (Netherlands)
  • 3 Clintec, Karolinska Institutet, Stockholm, Sweden. , (Sweden)
  • 4 Brainlink B.V., Groningen, the Netherlands. , (Netherlands)
  • 5 CAN Holding B.V., Groningen, the Netherlands. , (Netherlands)
  • 6 Department of Pharmaceutical Analysis, Faculty of Science and Engineering, University of Groningen, Groningen, the Netherlands. , (Netherlands)
  • 7 Department of Obstetrics & Gynecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. , (Netherlands)
Type
Published Article
Journal
Acta Obstetricia Et Gynecologica Scandinavica
Publisher
Wiley (Blackwell Publishing)
Publication Date
Oct 01, 2020
Volume
99
Issue
10
Pages
1411–1416
Identifiers
DOI: 10.1111/aogs.13865
PMID: 32274792
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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, pco2 , and saturation. Lactate levels in dialysate were compared with plasma lactate levels. 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 R2 of .78 in the corresponding linear regression. 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. © 2020 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

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