The introduction of umbilical artery lactate sampling as a tool to improve intrapartum care in South Africa

Perinatal mortality remains one of the most pressing global health problems and the ability to identify and manage acute intrapartum hypoxia as one of the major causes of mortality is a significant clinical challenge. The capacity to achieve this in low and middle income countries forms the basis of this thesis, with a specific focus on South Africa. I undertook a comprehensive series of clinical trials and data set analyses based on the central concept of measuring acidosis at birth from an umbilical cord sample in order to provide quality of care feedback to clinicians and improve intrapartum care.