In 83 specimen of amniotic fluid both a dynamic measurement of the surface tension by the Wilhelmy-balance and a determination of the lecithin-sphingomyelin-ratio were performed in 1987-1992 in order to predict a respiratory-distress-syndrome (RDS) of the newborn. 7 cases showed divergent results of both methods. In comparison with the measurement of surface tension by the Wilhelmy-balance, determination of the lecithin/sphingomyelin-ratio showed more false positive results (4:1). Both methods provided false negative results in two cases each. In two cases both methods showed false positive results, with RDS occurring in spite of predicted lung maturity. In our high risk-collective 5 of 83 newborns developed a severe RDS. All of them were delivered by caesarean section. A secondary deficiency of surfactant as a result of fetal hypoxia or acidosis as well as a possible influence of the way of delivery might be responsible for the development of RDS. The Wilhelmy-balance, which can be used as a bed-side-method, provides similar results in the prediction of fetal lung maturity compared to the L/S-ratio.

Amniocentesis↗

PubMedDate not supplied

[Discrepancy between Apgar score and umbilical artery pH value in the newborn infant. (Correlation to mode of delivery and fetal outcome?)].

In a retrospective study data from more than 9000 live births were analyzed. Our aim was to compare the significance of Apgar-Score and umbilical artery pH in predicting the condition and development of the newborn. We were particularly interested in three groups of patients: "Group A" included patients with a 5 minute Apgar-Score < or = 7 and a normal pH > 7,2. In "Group P" the pH was < 7,10 combined with a normal Apgar-Score (8 to 10). Both groups were compared with a "normal group" (pH > 7,20 and Apgar-Score between 8 and 10). There was a higher percentage of operative deliveries in group A (38%) and group P (20%) compared to the normal group (15%). The only predictor of a low Apgar-Score was meconium stained amniotic fluid (Group A 16%). A poor condition of the newborn correlated much better with a low Apgar-Score than with a low umbilical artery pH. In group A the rate of newborns transferred to the neonatology unit was 43% and the perinatal mortality rate was 50%. The poor correlation of a low umbilical artery pH and the fetal outcome is partly explainable by the standard cut off level of 7,20 for acidosis, which seems to be too high.

Acid-Base Equilibrium↗