ObsteCare
AFL™ (Amniotic Fluid Lactate) Test
AFL™ (Amniotic Fluid Lactate) Test
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The Background
About 20% of all delivering mothers suffer from dysfunctional labour. This often results in extremely long deliveries which puts heavy strain on mother, baby, and the resources of the delivery wards. Many of these women end up finally delivering their baby by caesarean, ventouse or forceps.
About 20% of all delivering mothers suffer from dysfunctional labour. This often results in extremely long deliveries which puts heavy strain on mother, baby, and the resources of the delivery wards. Many of these women end up finally delivering their baby by caesarean, ventouse or forceps.
New research shows that it is possible to predict which women are going to suffer from dysfunctional labour. By monitoring AFL™ (Amniotic Fluid Lactate) level, predictions of outcome are possible at an early stage in the delivery.
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Amniotic Fluid Lactate (AFL) Testing
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Amniotic Fluid Lactate (AFL) Testing
where to next?
ObsteCare
AFL ™ (Amniotic Fluid Lactate) Test
key features
AFL ™ (Amniotic Fluid Lactate) Test
key features
• a uterus in stress releases lactic acid, which is reflected by AFL
• ObsteCare AFL measures lactic acid in amniotic fluid, this is an
intervention guiding tool during dysfunctional labour
• increase probability for spontaneous delivery
• avoid unnecessary strain through long labour
• avoid unnecessary strain on labour ward resources
• easy to use product
• non-invasive procedure
• ensure patient safety procedure during dysfunctional labour
• service and software upgrades included
• new, patented technology
• ObsteCare AFL measures lactic acid in amniotic fluid, this is an
intervention guiding tool during dysfunctional labour
• increase probability for spontaneous delivery
• avoid unnecessary strain through long labour
• avoid unnecessary strain on labour ward resources
• easy to use product
• non-
• ensure patient safety procedure during dysfunctional labour
• service and software upgrades included
• new, patented technology
The Science
It has been shown in several studies that the uterus, like other muscles, is a lactate producer. There is substantial evidence that a raised lactate level in the uterine muscle leads to inhibition of muscle contractions. This is described as a “dysfunctional labour” or a “labour dystocia”.
It has been shown in several studies that the uterus, like other muscles, is a lactate producer. There is substantial evidence that a raised lactate level in the uterine muscle leads to inhibition of muscle contractions. This is described as a “dysfunctional labour” or a “labour dystocia”.
Studies have shown that the lactate level in the uterus is reflected by the lactate level in amniotic fluid - the AFL.™
Studies have also shown that high levels of amniotic fluid lactate during dysfunctional labour:
• is a strong indication that using oxytocin will not improve the probability for a spontaneous vaginal delivery and that the delivery will end in operative intervention.
• is, together with an abnormal CTG, associated with adverse neonatal outcome at delivery.
Studies have also shown that high levels of amniotic fluid lactate during dysfunctional labour:
• is a strong indication that using oxytocin will not improve the probability for a spontaneous vaginal delivery and that the delivery will end in operative intervention.
• is, together with an abnormal CTG, associated with adverse neonatal outcome at delivery.
• is associated with increased risk for maternal complications.
The Practice
A skilled obstetrician is often faced with a situation where the progress of labour has been arrested and the Action Line in the partogram has been passed. In this case, AFL™ testing is a tool to support a correct clinical decision.
A skilled obstetrician is often faced with a situation where the progress of labour has been arrested and the Action Line in the partogram has been passed. In this case, AFL™ testing is a tool to support a correct clinical decision.
If the AFL™ level is low during dysfunctional labour, oxytocin is most likely still effective and can be administered in accordance with clinical practice.
If a high level of AFL™ is measured, this is indicative of an exhausted or overstimulated uterus. In this case, stimulating labour with oxytocin could be likened to asking an already exhausted marathon runner to run an extra 10,000 metres after they have already passed the finish line. In this situation, giving the uterus time to rest by stopping administration of oxytocin is one effective way of handling the situation.
If high AFL™ levels are appropriately taken care of during active labour, the probability of a spontaneous vaginal delivery is increased and an unnecessary operative delivery and associated complications can be avoided.
The Product
ObsteCare’s uterus monitoring system collects samples of amniotic fluid during labour and analyses them at Point-of-Care for the concentration of lactate. By combining the information on this concentration with cervix dilation, a thorough understanding of the delivery status is obtained.
ObsteCare’s uterus monitoring system collects samples of amniotic fluid during labour and analyses them at Point-
The system, named DMS061, is a dedicated and patented system for AFL™ measurement. This is the only AFL™ system on the market. The system comes with a complete service and software update guarantee which ensures your investment is safe and that as soon as any upgrades are developed they will be passed on.
The product is designed to be easy to install, use and maintain. There is also an emphasis on clinical use, and when introducing the new product, training is always part of the package.
This partogram shows a dysfunctional labour where no consideration has been given to the high levels of AFL™. The oxytocin administration is close according to plan (max normal dose is 120ml/hour), with slight changes. It ended with a caesarean delivery.
The AFL™ level is high indicating the uterus is exhausted. What would have been the outcome if oxytocin was stopped totally, giving the uterus a chance to rest? Could an operative delivery have been avoided?
The AFL™ level is high indicating the uterus is exhausted. What would have been the outcome if oxytocin was stopped totally, giving the uterus a chance to rest? Could an operative delivery have been avoided?
The benefits of Obstecare’s Amniotic Fluid Lactate testing has been picked up by the BBC in an article, Test Could Predict Which Mothers will Need Caesareans. They acknowledge that “Prolonged labours which end up in a Caesarean section are seen by many as the worst of all worlds”, and that Obstecare’s AFL™ test “could help decide whether to end a difficult labour and opt for a Caesarean earlier”.
BBC features Obstecare
