RESUMO
Since hyaline membrane disease (HMD) is an important cause of mortality and morbidity in preterm newborns, we decided to evaluate the utility of pulmonary phospholipid (PP) determination in gastric aspirate for confirmatory diagnosis. For that purpose we studied 31 preterm and 30 term babies and compared the results between them and PP in gastric aspirate and amniotic fluid from their mothers. All the term newborns were normal, with mean weight of 3,221, and 39 weeks of gestational age; the results of phosphatidyl inositol (PI) and phosphatidyl glycerol (PG) were positive. The premature babies had a mean weight of 2,424 g and 35 weeks of gestational age. Thirteen had respiratory distress, 4 transient tachypnea and 9 HMD. In this group the babies with PI present and PG absent developed respiratory distress without HMD. The test had sensibility of 69% and specificity of 100%, and in patients without PG and PI the sensibility and specificity was 100%. We concluded that this test has enough sensibility and specificity for the confirmation of HMD in gastric aspirate when the PI and PG are not present.
Assuntos
Conteúdo Gastrointestinal/química , Surfactantes Pulmonares/análise , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico , Cromatografia em Camada Fina , Humanos , Doença da Membrana Hialina/diagnóstico , Recém-Nascido , Recém-Nascido Prematuro , Fosfatidilgliceróis/análise , Fosfatidilinositóis/análise , Sensibilidade e EspecificidadeRESUMO
A total of 82 patients with 28 to 36 weeks of pregnancy, with a average of 61 hours after premature rupture of membranes, were studied. The greatest frequency was seen from 30 to 33 weeks (57%). Phosphatidylglycerol determination in the first sample was positive in 64% of the patients. The conservative management is adequate only up to 32 weeks; thereafter, and with phosphatidyiglycerol present, pregnancy interruption, after an adequate materno-fetal evaluation, will mean a better prognosis for mother and child.
