Bottom Line:

-Limited data, vulnerable population

-Consider interpreting the serum lactate concentrations for pregnant adults as you would for non-pregnant adults.

Study 1: Lactic Acid Measurement to Identify Risk of Morbidity from Sepsis in Pregnancy

-Retrospective cohort study of pregnant/postpartum adults evaluated in the ED with suspected SIRS/sepsis.

-Elevated lactate levels indicated the need for higher level of care.

    -ICU admit, 2.6 mmol/L (p £ 0.04)

    -Telemetry unit, 2.0 mmol/L (p £ 0.03)

    -Non-admit reference, 1.6 mmol/L

-AOR of a transfer to the ICU/telemetry unit for each 1 mmol/L increase of lactate concentration was 2.34 (95% CI, 1.33-4.12)

-Concluded that elevated lactate levels in pregnant/postpartum adults with clinically suspected sepsis is associated with adverse maternal outcomes.

Study 2: Evaluation of Point-of-Care Maternal Venous Lactate Testing in Normal Pregnancy

-Prospective observational study of venous lactate levels collected during pregnancy.

-Mean Serum Lactate, mmol/L

   -Study reference range, non-pregnant adults: 0.30-1.30

   -Gestational age, 6-18 weeks: 0.86 ± 0.46 (n=199)

     -Gestational age, 36-42 weeks: 1.15 ± 0.40 (n=47)

-Concluded that the serum lactate reference range for non-pregnant adults may be considered in early and late pregnancy.

References:

Albright CM, Ali TN, Lopes V, et al. Lactic Acid Measurement to Identify Risk of Morbidity from Sepsis in Pregnancy. Am J Perinatol. 2015;32(5):481-486.

Maguire PJ, Finlay J, Power KA, et al. Evaluation of Point-of-Care Maternal Venous Lactate Testing in Normal Pregnancy. J Matern Fetal Neonatal Med. 2016;29(16):2607-2610.