Swedish healthcare company Obstecare has developed a test that can predict whether a woman is likely to need a c-section during labour. The AFL (Amniotic Fluid Lactate level) test is based on findings from Liverpool University and Liverpool Women’s Hospital, UK, where researchers have established a link between lactic acid levels in the uterus and the type of birth a woman will have.
What Causes a Difficult Labour?
Professor Susan Wray and her team at Liverpool University tested blood samples from 72 women post-caesarian. The results showed that acid levels in uterine blood were higher in those women who had experienced a difficult labour. When the uterus works hard it produces lactic acid, as other muscles do when we exercise and this stimulates powerful contractions, which help push the baby along the birthing canal.
They discovered that when lactic acid reaches a certain level, it becomes counter-productive, inhibiting the contractions. This is known as "dysfunctional labour" and it can lead to delivery via forceps, ventouse or by emergency caesarean. “The results of this study suggest that a build-up of acid is the cause of many dysfunctional labours, which account for 25% of all caesarean section births in the UK,” said Professor Wray. “It also suggests that a correction of uterus acidity levels may lead to the recovery of the uterus and remove the need for a caesarean section.”
The Use of Oxytocin in Labour
Johan Ubby of Obstecare says that the test will help medics to establish early on in labour whether a woman is likely to deliver a child vaginally. It will enable them to assess how exhausted the uterus is, and whether or not it is viable to administer oxytocin (a drug used to stimulate contractions, which doesn't work in all cases). “A higher level of lactic acid in the amniotic fluid indicates that the uterus is exhausted. To stimulate this kind of labour with an oxytocin infusion would be like asking a marathon runner to run an extra 10,000 miles after he or she passes the finishing line,” he said.
Preventative Health Studies
If the AFL test proves to be consistent after larger scale studies, it will be a huge step forward in terms of preventing difficult, protracted labours, and making childbirth a more positive experience. It will give women some control back over the birthing process, if they know at the start of labour that a vaginal birth isn’t an option. The next step forward is to identify what causes an accumulation of lactic acid in the uterus to see if this can be reversed, preventing the need for invasive procedures and emergency surgery.
Source:
The Department of Physiology, University of Liverpool, UK
Liverpool Women's Hospital, UK
The Royal College of Obstetricians and Gynaecologists, UK
Clinical References
*" Lactate concentration in amniotic fluid: a good predictor of labor outcome." Wiberg-Itzel E et al. The European Journal of Obstetrics & Gynecology and Reproductive Biology, published 7th June 2010 (accessed 13th September 2010)
*"Association between lactate concentration in amniotic fluid and dysfunctional labor. " Wiberg-Itzel E et al, Acta Obstetricia et Gynecologica Scandinavica 2008:1-5, published Aug 11 (accessed 13th September 2010)
*" Dysfunctional labor and myometrial lactic acidosis." Obstetrics & Gynecology 103(4): p. 718-23, published 2004 (accessed 13th September 2010)
*" Insights into the uterus" by Professor Susan Wray, Experimental Physiology 2007; 92; 621-631 (accessed 13th September 2010)
Nicci Talbot - Nicci Talbot is a journalist and author specialising in sex, health & wellbeing. She edits Rude Magazine, an online resource for better ...
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