255 Penicillin Prophylaxis and Group B Streptococcus Sepsis

255 Penicillin Prophylaxis and Group B Streptococcus Sepsis

368 SPO Abstracts 254 ABNORMAL SURFACTANT PRODUCTION IN THE LAMB CONGENITAL DIAPHRAGMATIC HERNIA MODEL. DT Wilcoxx, PL Glick, V stannard, BA Holm. D...

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368

SPO Abstracts

254 ABNORMAL SURFACTANT PRODUCTION IN THE LAMB CONGENITAL DIAPHRAGMATIC HERNIA MODEL. DT Wilcoxx, PL Glick, V stannard, BA Holm. Depts of Ob/Gyn and Pediatric surgery, bniversity of Buffalo, Children's Hospital of Buffalo, NY. objective: To characterize the pulmonary surfactant system and type II cell metabolism in the lamb CDH model. Study design: CDH was created surgically in fetal lambs at 80 days. CDH and control lambs were delivered at 140 days. Bronchoalveoalar lavage (BAL) was performed, proteins and phospholipids were analyzed. Type II cells were isolated. Phospholipid synthesis was assayed via choline incorporation. Results were compared by t-test. Results Phos

phosphot; pi ds X cOIIIJlOS it i on choline SPH PC PE PI PG ~l Control 195 8.10 5.03 4.16 67.3 11.4 3.49 6.84 90 (8 ) (1.2) (2.4) (0.3) (5.2) (2.3) (1.9) (1.4) n=5 (40) CDH 545 1.68 13.5 6.3 47.3 12.9 7.48 9.13 20 (15) (0.4) (2.5) (1.7) (7.1> (1.7) (1.2) (2.5) n=5 (10) *P<0.05 * * Data given as mean (standard error mean) Prot

-=lIIa -=lIIa LPC

Conclusion: The lamb CDH model is surfactant deficient, which appears to be related to type II cell dysfunction.

January 1993 Am J Obstet Gynecol

SEPSIS. 255 PENICILLIN XPROPHYLAXIS AND GROUP B STREPTOCOCCUS D.M. Patel , S.P. Chauhan'<, P.G. Rhodesx , G.R. Graves x, Depts. Ob/Gyn and J.N. Martin, Jr., J.C. Morrison. Pediatrics, University of Mississippi Medical Center, Jackson, MS. OBJECTIVE: To study the effect of penicillin prophylaxis (PP) in the neonate and incidence of group B streptococcus (GBS) sepsis. STUDY DESIGN: In this retrospective, descriptive study, 17 months (period 1 • PRl) when neonatal PP was given within 1 hour of birth (intramuscularly) was compared to the next 12 months (period 2 • PR2) where PP was not used. Charts of 140 infants with positive (+) urine latex (UL) for GBS and/or + blood culture (BC) for GBS were reviewed. Infants with a negative BC but a + UL were considered clinically septic if they met> 5 of 8 clinical and laboratory criteria. Chi-square wfth Yates Correction or Fisher Exact test were used for statistical analysis. RESULTS: For PRl, the total number of infants was 5568 (group 1 • GRl), of which 5199 were> 1500 g (group 2 • GR2) and 369 were < 1500 g (group 3 • GR3). For PR2, there were 3787 in GR1, of which 3537 were in GR2 and 250 in GR3. During PRl, the incidence of Clinical sepsis and/or + BC per 1000 was 4.8 in GRl, it was 2.9 in GR2 and 32 in GR3 versus during PR2, where it was 8.7, 6.5, and 40 in GRl, 2, and 3, respectively (p • 0.03, 0.02, and 0.8 for GRl, 2, and 3, respectively). During PRl, there were two, 0, and 2 neonates in GRl, 2, and 3 respectively versus during PR2, five, 4, and 1 neonates in GRl, 2, and 3, respectively who expired (p • 0.2, 0.056, and 0.8, respectively). CONCLUSION: Penicillin prophylaxis did reduce the overall incidence of GBS, but this was not different from baseline incidence reported in the literature. It did not change the incidence in the < 1500 g infant nor did it significantly reduce the mortality in any group, although there was a trend towards improved survival in those > 1500 g. Further study using a randomized protocol is underway.