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The clinical significance of a nonreactive nonstress test followed by a normal biophysical profile
342
297
SPO Abstracts
TEE C L I N I C A L S I G N I F I C I A N C E OF A N O N R E A C T I V E N O N S T R E S S T E S T F O L L O W E D BY A N O R M A L B I O P H Y S I C A L PROFILE. J. CanterinG*, J. Harrigan, E. Smith* , J e r s e y Shore M e d i c a l Center, Neptune, NJ. OBJECTIVE: To d e t e r m i n e the clinical s i g n i f i c a n c e of a n o n r e a c t i v e n o n - s t r e s s test (NST) followed by a normal b i o p h y s i c a l profile (BPP). STUDY DESIGN: Nine h u n d r e d and forty four patients w e r e e v a l u a t e d by serial NST. Patients w i t h a n o n r e a c t i v e NST w e r e e v a l u a t e d by a BPP. M a n a g e m e n t was based on the o u t c o m e of the BPP. O u t c o m e indicators w e r e c e s a r e a n section for fetal distress, low 5 m i n u t e A p g a r score and a d m i s s i o n to neonatal i n t e n s i v e care (NICU). Statistical analysis was by chi-square. RESULTS: Sixty-five patients exhibited a n o n r e a c t i v e NST f o l l o w e d by a normal BPP at one or more times during their pregnancy. S e v e n t e e n p a t i e n t s d e v e l o p e d fetal distress. A s i g n i f i c a n t l y g r e a t e r i n c i d e n c e of fetal d i s t r e s s o c c u r r e d prior to or during labor in the n o n r e a c t i v e NST g r o u p 17/65 (26%) c o m p a r e d to the c o n t i n u o u s l y r e a c t i v e g r o u p 40/879 (5%) (x 2= 46.052) (P= .00001). There was no d i f f e r e n c e in Apgar scores or NICU admissions. CONCLUSIONS: Patients with a n o n r e a c t i v e NST/normal BPP are at g r e a t e r risk for fetal distress than p a t i e n t s w i t h a c o n t i n u o u s l y reactive NST.
January 1995 Am J Obstet Gynecol
298
T H E R M O C H E M I L U M I N E S C E N C E - A N E W M E T H O D FOR ASSESSING F E T A L L U N G M A T U R I T Y . S. Shnitzer', R. G o n e n , E. Taycher , A . L a n i r , R.M. L e w i n s k y , I. Samberg'.
Departments of Biochemistry and Obstetrics & Gynecology, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa Israel. OBJECTIVE: To test a new method for rapid fetal lung maturity determination based on thermochemiluminescence (TCL). STUDY DESIGN: We have developed a fully automated thermochemiluminometer, capable of measuring light emission at 400-600 mv, upon heating a sample of amniotic fluid. We assessed the variation in TCL spectrum and intensity with gestational week and by comparing it with L/S ratio. RESULTS: We assessed 75 samples between 17 - 41 weeks' gestation. TCL intensity remained below 180 mv up to 32 weeks, and rapidly increased thereafter. This increase parallelled the increase of the L/S ratio (r = 0.89). To overcome the possible dilution effect we also measured the ratio of emitted light at 450/550 nm. This ratio significantly increased with gestation. CONCLUSIONS: TCL of the amniotic fluid correlates with gestation and the L/S ratio. Being a rapid technique it may have an advantage over existing methods for fetal lung maturity assessment.
297
SPO Abstracts
TEE C L I N I C A L S I G N I F I C I A N C E OF A N O N R E A C T I V E N O N S T R E S S T E S T F O L L O W E D BY A N O R M A L B I O P H Y S I C A L PROFILE. J. CanterinG*, J. Harrigan, E. Smith* , J e r s e y Shore M e d i c a l Center, Neptune, NJ. OBJECTIVE: To d e t e r m i n e the clinical s i g n i f i c a n c e of a n o n r e a c t i v e n o n - s t r e s s test (NST) followed by a normal b i o p h y s i c a l profile (BPP). STUDY DESIGN: Nine h u n d r e d and forty four patients w e r e e v a l u a t e d by serial NST. Patients w i t h a n o n r e a c t i v e NST w e r e e v a l u a t e d by a BPP. M a n a g e m e n t was based on the o u t c o m e of the BPP. O u t c o m e indicators w e r e c e s a r e a n section for fetal distress, low 5 m i n u t e A p g a r score and a d m i s s i o n to neonatal i n t e n s i v e care (NICU). Statistical analysis was by chi-square. RESULTS: Sixty-five patients exhibited a n o n r e a c t i v e NST f o l l o w e d by a normal BPP at one or more times during their pregnancy. S e v e n t e e n p a t i e n t s d e v e l o p e d fetal distress. A s i g n i f i c a n t l y g r e a t e r i n c i d e n c e of fetal d i s t r e s s o c c u r r e d prior to or during labor in the n o n r e a c t i v e NST g r o u p 17/65 (26%) c o m p a r e d to the c o n t i n u o u s l y r e a c t i v e g r o u p 40/879 (5%) (x 2= 46.052) (P= .00001). There was no d i f f e r e n c e in Apgar scores or NICU admissions. CONCLUSIONS: Patients with a n o n r e a c t i v e NST/normal BPP are at g r e a t e r risk for fetal distress than p a t i e n t s w i t h a c o n t i n u o u s l y reactive NST.
January 1995 Am J Obstet Gynecol
298
T H E R M O C H E M I L U M I N E S C E N C E - A N E W M E T H O D FOR ASSESSING F E T A L L U N G M A T U R I T Y . S. Shnitzer', R. G o n e n , E. Taycher , A . L a n i r , R.M. L e w i n s k y , I. Samberg'.
Departments of Biochemistry and Obstetrics & Gynecology, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa Israel. OBJECTIVE: To test a new method for rapid fetal lung maturity determination based on thermochemiluminescence (TCL). STUDY DESIGN: We have developed a fully automated thermochemiluminometer, capable of measuring light emission at 400-600 mv, upon heating a sample of amniotic fluid. We assessed the variation in TCL spectrum and intensity with gestational week and by comparing it with L/S ratio. RESULTS: We assessed 75 samples between 17 - 41 weeks' gestation. TCL intensity remained below 180 mv up to 32 weeks, and rapidly increased thereafter. This increase parallelled the increase of the L/S ratio (r = 0.89). To overcome the possible dilution effect we also measured the ratio of emitted light at 450/550 nm. This ratio significantly increased with gestation. CONCLUSIONS: TCL of the amniotic fluid correlates with gestation and the L/S ratio. Being a rapid technique it may have an advantage over existing methods for fetal lung maturity assessment.