Clinical Estimation of L/S rations in the Neonatsl Lung by a Foam Stability Test / 대한마취과학회지

ABSTRACT

Respiratory distress syndrome(RDS) in the newborn infants is a problem of great importance, not only to the obstetrician and pediatrician but also to the anesthesiologist. RDS is a frequent result of premature birth and occasionally occurs in full term infants. The need for estimation of fetal maturity by amniocentesis is especially indicated when early termination of pregnancy is required in cases of diabetes, Rh sensitization, hypertensive, poor obstetrical history and onset of premature labor, when the decision to attempt to stop labor must be made. A Foam-stability test was performed on 54 samples of amniotic fluid to assess its practical value as a rapid method of confirming adequate surface activity in the neonatal lung. The results of the test were compared with the lecithin-sphingomyelin ratio, gestational age, birth weight and clinical RDS. The results obtained were as follows 1) Of the 46 cases with the foam test positive, none of the new born infants developed clinical RDS and their mean L/S ration was 3.6+/-0.2. 2) All of the newborn infants with the foam test negative developed clinical RDS and their mean L/S ration was 1.5+/-0.2. 3) In 5 cases with an intermediate test, one who had L/S ration 2.0 showed mild and transient clinical RDS. 4) These results suggest that the foam test is a reliable index of neonatal lung maturity and high predictive value for RDS, when applied to uncontaminated amniotic fluid.