Project details – junior scientific masterclass groningen anoxia e hipoxia

Of

Development and validation of a novel microdialysis probe for continuous intrapartum fetal lactate monitoring

Keywords:

Perinatal death analytical chemistry lactate sensor

Researchers:

Dr. H. Groen

Prof. Dr. P.P. Van den berg

K. Huinink

Nature of the research:

Validation of the analytical method for continuous measurement of lactate in healthy volunteers

Fields of study:

Biomaterials epidemiology obstetrics

Background / introduction

Fetal monitoring during labour is generally performed by electronic fetal heart rate monitoring. (EFM). Normal tracings indicate that the fetus is well oxygenated. In nearly half of all tracings, however, the results are not reassuring but only a small proportion of these fetuses are actually hypoxic.Anoxia e hipoxia


since the introduction of EFM cesarean delivery rates have risen dramatically from 5 to 35% and higher, but there is no evidence that EFM has reduced the rate of hypoxia-induced neonatal encephalopathy. A better method to determine fetal hypoxia is needed to prevent unnecessary obstetric interventions.

In collaboration with brainlink, a company located on the zernike campus, a new microdialysis probe has been developed and patented that can be integrated into the device already used for EFM. The microdialysis probe allows continuous measurement of lactate, giving optimal insight into the condition of the fetus and providing obstetricians with the best possible information to determine whether an intervention is necessary because of fetal distress.Anoxia e hipoxia

A proof of principle study in animals has been performed successfully. The prototype of the probe and the method that samples are collected and analyzed needs to be developed further before it can be tested in healthy volunteers during exercise. A protocol for this study has been approved by the medical ethics committee.

Research question / problem definition

The following aspects of the probe will be studied:

1 development and validation of the analysis of lactate in microdialysis samples

2 adaptation of the prototype for use in healthy volunteers

3 performing the study in healthy volunteers

Workplan

The project will start as soon as possible and will take approximately 3 months. The following activities will be carried out:

anoxia e hipoxia

1 perform validation of the analysis of lactate

2 prepare healthy volunteer study with application of continuous lactate monitoring during physical exercise on a bicycle ergometer (anticipated to start in the end of 2017, depending on the time needed for the validation)

References

1. Belfort MA, saade GR, thom E, blackwell SC, reddy UM, thorp JM,jr, et al. A randomized trial of intrapartum fetal ECG ST-segment analysis. N engl J med. 2015 aug 13;373(7):632-41.

2. Liljestrom L, wikstrom AK, hanson U, akerud H, jonsson M. Evaluation of the discrepancy between ph and lactate in combined fetal scalp blood sampling. Acta obstet gynecol scand. 2011 oct;90(10):1088-93.

3. Pyne DB, boston T, martin DT, logan A.Anoxia e hipoxia evaluation of the lactate pro blood lactate analyser. Eur J appl physiol. 2000 may;82(1-2):112-6.

4. Wiberg-itzel E, lipponer C, norman M, herbst A, prebensen D, hansson A, et al. Determination of ph or lactate in fetal scalp blood in management of intrapartum fetal distress: randomised controlled multicentre trial. BMJ. 2008 jun 7;336(7656):1284-7.