COMPARISON OF THE LACTATE-PYRUVATE RATIO DURING LABOR AND DELIVERY INSINGLETON AND TWIN PREGNANCY

Oxygen utilisation at the tissue level was investigated by the use of lactate-pyruvate (LP) ratio in forty women; twenty with term twin preg nancy, with a matched controlled group of twenty women with term singl eton pregnancy. The lactate-pyruvate ratio in twin pregnancy was signi ficantly higher than in singleton pregnancy at term (p<0.05). There wa s also significantly higher LP ratio in advanced labour in twin pregna ncy than in singleton pregnancy (p<0.001). Similarly the venous cord b lood LP ratio of twin II was higher than in twin I. Our findings have thus demonstrated more marked anaerobic metabolism in twin pregnancy t han in singleton pregnancy. Secondly, the second twin is more involved in anaerobic metabolism as a result of relative oxygen deficiency, th an twin I. This may to some extent account for the higher morbidity an d mortality in twin pregnancy, compared to singleton pregnancy, and in twin II compared to twin I.