Prevalence and etiology of respiratory distress in infants of diabetic mothers: predictive value of fetal lung maturation tests

Article Abstract:

Respiratory distress syndrome (RDS) is a serious impairment of breathing in newborn infants resulting from a lack of surfactant, a substance that lowers surface tension in the lung. RDS is often associated with premature birth. Although infants of diabetic mothers are thought to be at increased risk for surfactant-deficient RDS, some research reports have not found delayed lung maturation in such infants. To learn more about this issue, the outcome of pregnancy for 526 diabetic women was studied; all had undergone testing to determine the level of maturation of the fetal lungs. Three measures of fetal lung maturation were compared: (1) the lecithin/sphingomyelin ratio; (2) the phosphatidylglycerol concentration; and (3) the optical density of amniotic fluid (the fluid in which the fetus floats, removed during a procedure called amniocentesis). Eighteen infants had signs of respiratory distress within the first six hours of life, of whom five had surfactant-deficient RDS; five had transient tachypnea (rapid breathing) of the newborn; four had enlarged hearts; two had pneumonia; and two had other conditions. All neonates with surfactant-deficient RDS were identified by each of the three tests, and no infant whose tests indicated maturity of the lungs had surfactant-deficient RDS. The optical density test appeared excellent for evaluating these diabetic pregnancies. But on the whole, surfactant-deficient RDS was rare in these infants of diabetic mothers; most respiratory distress was associated with other conditions. Therefore the need to do fetal lung maturation testing in infants born to diabetics is questioned. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Testing, Causes of, Risk factors, Respiratory distress syndrome, Pulmonary surfactant, Pulmonary surfactants

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Antepartum surveillance in diabetic pregnancies: predictors of fetal distress in labor

Article Abstract:

Routine evaluation of amniotic fluid in pregnancies complicated by diabetes may not be necessary at frequent intervals to detect fetal distress. Researchers performed amniotic fluid analysis and fetal nonstress tests twice a week on 2,134 diabetic pregnant women. A total of 1,501 women gave birth within four days of a nonstress test, and none of these women had stillborn infants. Poor blood sugar control was the main reason for inducing delivery before term in these women. Fetal distress necessitated the cesarean delivery of 85 of the 1,501 infants. The remaining women experienced five stillbirths, a rate of 1.4 per 1,000. Routine amniotic fluid evaluation did not detect fetal distress as well as nonstress tests that did not elicit a fetal response. Amniotic fluid tests may be limited to once a week rather than twice a week.

Diagnosis, Fetal distress

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Umbilical arteriovenous PO2 and PCO2 differences and neonatal morbidity in term infants with severe acidosis

Article Abstract:

A discrepancy between carbon dioxide levels in the umbilical artery and vein might identify infants with asphyxia. Asphyxia occurs when the fetus does not receive enough oxygen. Researchers measured the level of oxygen and carbon dioxide in the umbilical artery and vein of 82 newborn infants with asphyxia. Different carbon dioxide levels in the umbilical artery and vein accurately predicted which infants would develop complications from asphyxia.

Measurement, Diseases, Infants (Newborn), Carbon dioxide, Neonatal diseases, Fetal anoxia, Blood gases, Carbon dioxide in the body

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