Respiratory distress syndrome Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2006;28(8):460-466
DOI 10.1590/S0100-72032006000800004
PURPOSE: to assess the performance of lamellar body count compared to the shake (Clements) test in the prediction of fetal lung maturity in diabetics. METHODS: prospective study of 62 patients who underwent amniocentesis between the 26th and 39th week of pregnancy. Immediately after collection, the amniotic fluid sample was submitted to the shake test and lamellar body count. Deliveries occurred within three days of amniocentesis. Immature test results (absence of a complete bubble ring in the third tube for the shake test and less than 50,000 lamellar bodies) were confronted with the occurrence of pulmonary immaturity in the neonate (respiratory distress syndrome). The performance of both tests was compared using the chi2 test and p<0.05 was considered to be significant. RESULTS: seven infants had respiratory distress syndrome (11.3%). The lamellar body count and shake test were similar regarding sensitivity (100 vs 71.4%, respectively) and negative predictive value (100 vs 93.5%). Lamellar body count was superior as regards specificity (87.3 vs 52.7%, p=0.0001), positive predictive value (50 vs 16.1%, p=0.017), and accuracy (88.7 vs 54.8%, p<0.001). CONCLUSIONS: lamellar body count is a simple and accurate method of assessing fetal lung maturity. It performs slightly better than the shake test in terms of specificity, positive predictive value and accuracy, with the advantage of not requiring manipulation or reagents. Similar to the shake test, lamellar body count has a high-negative predictive value: mature results (50,000 or more) indicate thar the infant will not have hyaline membrane.
Summary
Rev Bras Ginecol Obstet. 2006;28(8):460-466
DOI 10.1590/S0100-72032006000800004
PURPOSE: to assess the performance of lamellar body count compared to the shake (Clements) test in the prediction of fetal lung maturity in diabetics. METHODS: prospective study of 62 patients who underwent amniocentesis between the 26th and 39th week of pregnancy. Immediately after collection, the amniotic fluid sample was submitted to the shake test and lamellar body count. Deliveries occurred within three days of amniocentesis. Immature test results (absence of a complete bubble ring in the third tube for the shake test and less than 50,000 lamellar bodies) were confronted with the occurrence of pulmonary immaturity in the neonate (respiratory distress syndrome). The performance of both tests was compared using the chi2 test and p<0.05 was considered to be significant. RESULTS: seven infants had respiratory distress syndrome (11.3%). The lamellar body count and shake test were similar regarding sensitivity (100 vs 71.4%, respectively) and negative predictive value (100 vs 93.5%). Lamellar body count was superior as regards specificity (87.3 vs 52.7%, p=0.0001), positive predictive value (50 vs 16.1%, p=0.017), and accuracy (88.7 vs 54.8%, p<0.001). CONCLUSIONS: lamellar body count is a simple and accurate method of assessing fetal lung maturity. It performs slightly better than the shake test in terms of specificity, positive predictive value and accuracy, with the advantage of not requiring manipulation or reagents. Similar to the shake test, lamellar body count has a high-negative predictive value: mature results (50,000 or more) indicate thar the infant will not have hyaline membrane.
Summary
Rev Bras Ginecol Obstet. 2000;22(9):543-549
DOI 10.1590/S0100-72032000000900002
Purpose: to compare the efficiency between magnesium sulfate and phenytoin in the control of convulsions in patients with eclampsia and to evaluate the effects of magnesium sulfate and phenytoin on the maternal and perinatal prognosis in patients with eclampsia. Methods: this is a prospective, randomized and controlled study in which the results obtained with the use of anticonvulsive treatment in 77 women with eclampsia, treated with either magnesium sulfate or phenytoin, were analyzed comparatively. The drugs which were used in both therapeutic schemes were distributed in a one to one ratio, in randomly numbered boxes which presented similar characteristics. When a patient was admitted, a box was opened and its contents were given to the patient. Results: in the group whose patients were treated with magnesium sulfate, 19.5% had recurrent convulsions while in the group whose patients used phenytoin, 36.1% had new crises (p<0,05). The patients who were treated with magnesium sulfate showed a greater prevalence of postpartum hemorrhage (14,7%) than those to whom phenytoin was administered (2.7%) (p<0.05). In relation to the newborns, 17.0% of the group from mothers treated with magnesium sulfate presented respiratory distress as opposed to the group of newborns from mothers treated with phenytoin (11.8%), (p> 0,05). Conclusion: magnesium sulfate is shown to be more efficient than phenytoin in the control and the prevention of convulsions in patients with eclampsia. However, its utilization showed a higher prevalence of postpartum hemorrhage and respiratory distress. Phenytoin should be used in cases where the use of magnesium sulfate is contraindicated.
Summary
Rev Bras Ginecol Obstet. 2000;22(9):543-549
DOI 10.1590/S0100-72032000000900002
Purpose: to compare the efficiency between magnesium sulfate and phenytoin in the control of convulsions in patients with eclampsia and to evaluate the effects of magnesium sulfate and phenytoin on the maternal and perinatal prognosis in patients with eclampsia. Methods: this is a prospective, randomized and controlled study in which the results obtained with the use of anticonvulsive treatment in 77 women with eclampsia, treated with either magnesium sulfate or phenytoin, were analyzed comparatively. The drugs which were used in both therapeutic schemes were distributed in a one to one ratio, in randomly numbered boxes which presented similar characteristics. When a patient was admitted, a box was opened and its contents were given to the patient. Results: in the group whose patients were treated with magnesium sulfate, 19.5% had recurrent convulsions while in the group whose patients used phenytoin, 36.1% had new crises (p<0,05). The patients who were treated with magnesium sulfate showed a greater prevalence of postpartum hemorrhage (14,7%) than those to whom phenytoin was administered (2.7%) (p<0.05). In relation to the newborns, 17.0% of the group from mothers treated with magnesium sulfate presented respiratory distress as opposed to the group of newborns from mothers treated with phenytoin (11.8%), (p> 0,05). Conclusion: magnesium sulfate is shown to be more efficient than phenytoin in the control and the prevention of convulsions in patients with eclampsia. However, its utilization showed a higher prevalence of postpartum hemorrhage and respiratory distress. Phenytoin should be used in cases where the use of magnesium sulfate is contraindicated.
Summary
Rev Bras Ginecol Obstet. 2001;23(2):93-97
DOI 10.1590/S0100-72032001000200006
Purpose: to analyze the effect of betamethasone on the pregnancy of rats. Methods: thirty pregnant rats were divided into three groups of ten animals each. Group I -- the animals received betamethasone IM (1 mg/kg body weight, in 0.5 ml distilled water) on the 11th, 12th, 18th and 19th day of pregnancy. Group II -- the rats received distilled water (0.5 ml) IM on the 11th, 12th, 18th and 19th day of pregnancy. Group III - the rats did not receive any drug or vehicle. The animals were weighed on days 0, 7, 14 and on the 20th of pregnancy, and on the last day of weighing, the animals were sacrificed. The number of implantations, resorptions, fetuses, placentas, malformations, maternal and fetal mortality as well as the weight of the fetuses and placentas were obtained and analyzed. Results: our results show that the rats treated with betamethasone gained significantly less weight. Their fetuses had an average weight of 3.2 g compared with 3.75 g in the control group. The results regarding placental weight were 0.36 g vs 0.48 g, respectively. All these differences were statistically significant. Conclusions: betamethasone had a negative effect on the gain of weight of matrices, fetuses and placentas when administered repeatedly and continuousy after the second half of pregnancy.
Summary
Rev Bras Ginecol Obstet. 2001;23(2):93-97
DOI 10.1590/S0100-72032001000200006
Purpose: to analyze the effect of betamethasone on the pregnancy of rats. Methods: thirty pregnant rats were divided into three groups of ten animals each. Group I -- the animals received betamethasone IM (1 mg/kg body weight, in 0.5 ml distilled water) on the 11th, 12th, 18th and 19th day of pregnancy. Group II -- the rats received distilled water (0.5 ml) IM on the 11th, 12th, 18th and 19th day of pregnancy. Group III - the rats did not receive any drug or vehicle. The animals were weighed on days 0, 7, 14 and on the 20th of pregnancy, and on the last day of weighing, the animals were sacrificed. The number of implantations, resorptions, fetuses, placentas, malformations, maternal and fetal mortality as well as the weight of the fetuses and placentas were obtained and analyzed. Results: our results show that the rats treated with betamethasone gained significantly less weight. Their fetuses had an average weight of 3.2 g compared with 3.75 g in the control group. The results regarding placental weight were 0.36 g vs 0.48 g, respectively. All these differences were statistically significant. Conclusions: betamethasone had a negative effect on the gain of weight of matrices, fetuses and placentas when administered repeatedly and continuousy after the second half of pregnancy.
