TITLE:
Preoperative Sodium Bicarbonate Infusion and Maternal and Neonatal Outcomes in Prolonged Obstructed Labour at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki: A Randomized Control Trial
AUTHORS:
Chikezie Oyinyechi Nwaogwugwu, Ayodele Adegbite Olaleye, Nwabunike Ekene Okeke, Eziaha Samuel Eric Ede, Chidi Ikenna Ebere, Bartholomew Ifeanyi Olinya, Bobbie Chukwujioke Iwe
KEYWORDS:
Obstructed Labour, Prolonged Obstructed Labour, Metabolic Acidosis, Sodium Bicarbonate, Lactate
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.16 No.7,
July
15,
2026
ABSTRACT: Background: Prolonged obstructed labour is still among the common complications of labour in low resource countries. It becomes complicated by fluid and electrolyte imbalance that should be adequately corrected for better outcomes. Resuscitation with intravenous fluid and electrolyte replacement prior to Caesarean section do not wholly reverse the metabolic acidosis associated with prolonged obstructed labour. Metabolic acidosis is complicated by primary postpartum haemorrhage and birth asphyxia. Sodium bicarbonate as a buffer could effectively correct the metabolic acidosis. Objective: This study evaluated the effect of preoperative sodium bicarbonate infusion on maternal and fetal lactate levels as well as clinical outcomes in prolonged obstructed labour. Methods: An equivalence randomized control trial that was placebo-controlled in prolonged obstructed labour at Alex Ekwueme Federal University Teaching Hospital, Abakaliki determined the effectiveness of single dose preoperative sodium bicarbonate infusion in correcting metabolic acidosis. Fifty millilitre of 8.4% of 50 mmol/l sodium bicarbonate infusion was given to the intervention group and the other arm, placebo (50 ml of water for injection). Intravenous fluid, 1.5 litres of normal saline was given to both arms during resuscitation. Data were collated and analyzed using IBM SPSS software (version 20, Chicago IL, USA). Mean and standard deviation (mean ± 2 SD) showed the continuous variables. Numbers and percentages showed the categorical variables. Student’s t-test was used to compare the means between two groups of continuous variables. While Z-test was used to determine significance of statistical measures Chi squared test/Fisher exact test was used to determine relationship between categorical variables. The level of statistical significance was expressed as p-value and was taken to be significant if ≤0.05. Results: The median maternal capillary lactate level at one hour was 7.15 ± 1.97 mmol/l in the bicarbonate group and 7.61 ± 1.73 mmol/l in the control group with p value of 0.133 which was not statistically significant. The mean fetal arterial cord blood lactate level in the Bicarbonate arm, was significantly lower, 3.39 ± 0.95 mmol/l than the placebo group, 4.11 ± 1.05 mmol/l with p value Conclusion: 50 ml of 50 mmol/l of intravenous sodium bicarbonate infusion preoperatively, had no significant effect on maternal capillary blood lactate level at one hour following administration and this upholds the null hypothesis. It, however, significantly reduced fetal arterial cord blood lactate level at birth. It also significantly reduced birth asphyxia and newborn admission in Newborn intensive care unit. Post-partum haemorrhage was also significantly reduced. It is effective and safe.