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Use of fetal scalp blood lactate for assessing fetal well‐being during labour

A fetal heart rate that is abnormal or not reassuring during labour may be caused by the inability of the baby to adapt to decreases in oxygen supply during the birth. Inadequate oxygen supply may lead to the development of acidosis (low pH levels) and increased lactate in the blood. After the amniotic membranes have ruptured and the cervix dilated to around 3 cm, it is possible to measure lactate (or pH) levels in a sample of blood taken from the baby's scalp. A much smaller amount of blood is needed for the lactate test than to measure pH. This review identified two studies of 3348 mother‐baby pairs that compared lactate and pH testing in labour. Lactate testing was more likely to be successful than pH testing, but with no differences in newborn outcomes, including the number of babies with low Apgar scores, low pH in their cord blood or admissions to the neonatal intensive care nursery. There were no differences in the number of mothers having caesarean sections, forceps or vacuum births between the two groups. We conclude that lactate testing in labour may be more likely to be successfully achieved than pH testing.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

What are the treatment options for warts?

Warts are usually harmless and generally go away on their own after a few weeks or months. But they can be bothersome and unattractive. They may also be painful, especially on the feet. Various treatments can help warts go away faster.Warts are caused by human papillomaviruses (HPV), of which there are more than 100 different types. Warts are most common on your hands, feet, and face. They may also appear in the genital and anal area. This information does not cover the treatment of genital warts.Warts are particularly common in children and teenagers. They usually appear alone and often go away without treatment after a few weeks or months. So a lot of people decide not to have them treated and instead just wait until they disappear.But some people are unhappy and embarrassed about their warts, especially if they’re on a part of their body that others can easily see. And some have had a lot of warts for a long time. Many of them want an effective treatment.There are a number of different treatments that can improve the chances of getting rid of warts faster, but they do not always work. Warts on the soles of the feet are particularly hard to treat because they are sometimes pushed inward. No treatments have been proven to work here. Also, new warts may grow again after successful treatment because there might still be viruses in the skin cells.Warts are often treated with a salicylic acid solution or cryotherapy. These are also the best-studied treatments.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 4, 2017

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