The Probability of Neonatal Respiratory Distress Syndrome as a Function of Gestational Age and Lecithin/Sphingomyelin Ratio

Clair, Caryn St.; Norwitz, Errol R.; Woensdregt, Karlijn; Cackovic, Michael; Shaw, Julia A.; Malkus, H; Ehrenkranz, Richard A.; Illuzzi, Jessica L.

doi:10.1055/s-0028-1085066

Cited by 45 publications

(37 citation statements)

References 20 publications

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“…Determination of the L/S ratio is by far the most widely used and accepted method to assess for fetal lung immaturity, [18,20,21]. Possible sources of enzymes found in amniotic fluid are mother's blood and placenta [25,26].…”

Section: Discussionmentioning

confidence: 99%

“…Lecithin/sphingomyelin ratio was estimated by using a thin layer chromatography assay kit (Helena laboratory, Beaumont, Texas, USA). The L/S ratio of 0-1.5 points out to immature fetal lungs, the L/S ratio from 1.6 to 1.9 is considered to be borderline and, the L/S ratio over the 2.1 represents fetal lung maturity [21][22][23]. L/S ratio, over the 2.1 represents the values that may aid in clinical decision making concerning the timing of delivery and a mature fetal lung.…”

Section: Methodsmentioning

confidence: 99%

“…Determination of the L/S ratio is by far the most widely used and accepted method to assess for fetal lung immaturity [21,22].…”

Section: Introductionmentioning

confidence: 99%

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Arginase Activity and Lecithin/Sphingomyelin (L/S) Ratio in the Amniotic Fluid of Pregnant Women

et al. 2013

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Arginase activity is important in polyamines and nitric oxide production which are required for the normal growth of placenta and embryo. A considerable arginase activity is observed in amniotic fluid in women at the end of pregnancy. Lecithin to sphingomyelin (L/S) ratio is widely used in order to assess fetal lung immaturity and prevention of neonatal respiratory distress syndrome, the major cause of neonatal morbidity and mortality. The purpose of our study was to determine if there is a relationship between arginase activity and L/S ratio in amniotic fluid. The study included 170 pregnant women, 18-43 years old, with normal and pathological pregnancy. The arginase activity was measured on the basis of the determination of the amount of liberated ornithine from arginine as substrate. The L/S ratio was done by using a thin layer chromatography. Increased level of arginase activity correlates with the fetal lung maturity. Arginase activity and L/S values may be useful biochemical data, for intrauterine baby maturity.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Arginase Activity and Lecithin/Sphingomyelin (L/S) Ratio in the Amniotic Fluid of Pregnant Women

et al. 2013

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“…L/S ratio was estimated by a thin layer chromatography using assay kit (Helena laboratory, Beaumont, Texas, USA). The L/S ratio of 0-1.5 points out the immature fetal lungs, the L/S ratio from 1.6 to 1.9 is considered to be borderline and, the L/S ratio over the 2.0 represents fetal lung maturity [46], [47]. PAO (spermine-tetrahydrochloride "Sigma" was used as substrate) and DAO (putrescine-dihydrochloride "Sigma" was used as substrate) activities were measured by the spectrophotometric method of Bacharach and Reaches [48], modified by Quash et al [49].…”

Section: Methodsmentioning

confidence: 99%

Enzymes of polyamine biodegradation pathway in amniotic fluid during the pregnancy compared with values of L/S ratio

Bjelaković

Pavlović²,

Kocic³

et al. 2015

IJBAS

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Background: During the pregnancy the amount of polyamines spermine, spermidine and putrescine, rise rapidly in amniotic fluid. Polyamine oxidase (PAO) represents one of the key enzymes in catabolic pathway of polyamines. PAO catalyzes the oxidative deamination of spermine (Sp) or spermidine (Spd). The literature data documented that serum PAO activity increases in pregnancy. Diamine oxidase (DAO), histaminase, catalyses the oxidation of diamine putrescine or histamine. DAO is present in high concentrations in amniotic fluid. Amniotic fluid is the protective liquid for the baby in the mother's uterus. The determination of the lecithin to sphyngomyelin (L/S) ratio is by far the most widely used and accepted method to assess the fetal lung immaturity. The idea of the present study was to elucidate the polyamine metabolism in amniotic fluid during the pregnancy, through investigation of polyamine oxidase (PAO) and diamine oxidase (DAO) activities, and to compare their activities with the values of lecithin/ sphingomielin ratio (L/S) ratio. Methods: The study included 170 pregnant women. The amniotic fluid samples were obtained using amniocentesis. The values of L/S ratio were estimated by a thin layer chromatography. PAO and DAO activities were measured by the spectrophotometric methods. Results: Our results confirmed that amniotic fluid possess PAO and DAO activity. The activities of both enzymes in amniotic fluid samples increase in parallel with the L/S ratio increase. Diamine oxidase activity was higher than polyamine oxidase activity. Conclusions: DAO and PAO activities may serve as markers of fetal lung maturity.

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“…In fact many very early preterm babies, even if spontaneously breathing at birth, frequently need a respiratory support because of multiple gaps (i.e. poor respiratory diaphragm muscle strength, poor inspiratory pressure, high chest wall compliance, low lung compliance due to surfactant deficiency, neurological impairment and inefficient fluid clearance, etc) [1] . To reduce the occurrence or severity of respiratory distress, neonatologists have to plan an optimal respiratory strategy from the first breath and the nurses play a crucial role within the "working-team".…”

Section: Introductionmentioning

confidence: 99%

Non-invasive respiratory support and preterm infants: The crucial role of nurse management

Lista

Castoldi²,

Fontana³

et al. 2013

JNEP

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Premature delivery is often a failure of transition to create an early Functional Residual Capacity (FRC) and therefore preterm infants frequently need a respiratory support. To reduce the occurrence or severity of respiratory distress, neonatologists have to plan an optimal respiratory strategy from the first breath and within the "working-team" the nurses play a crucial role. Since duration of mechanical ventilation via the ET seems related to Bronchopulmonary Dysplasia (BPD), clinicians are increasingly using non invasive respiratory supports (e.g. n-CPAP and Non-Invasive Ventilation-NIV) to try to protect the preterm infant's lungs. Nurses are essential fundamental in choosing the best fitted devices and interfaces (e.g. hat, prongs), in protecting skin from infections, in taking a continuous care of the neonate to avoid nasal trauma, in maintaining and protecting parental bonding. The success of non-invasive respiratory support improves with staff experience and it is recognized that there is an urgent need for continuous education of nursing staff in preventing failure of non-invasive respiratory support.

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The Probability of Neonatal Respiratory Distress Syndrome as a Function of Gestational Age and Lecithin/Sphingomyelin Ratio

Cited by 45 publications

References 20 publications

Arginase Activity and Lecithin/Sphingomyelin (L/S) Ratio in the Amniotic Fluid of Pregnant Women

Arginase Activity and Lecithin/Sphingomyelin (L/S) Ratio in the Amniotic Fluid of Pregnant Women

Enzymes of polyamine biodegradation pathway in amniotic fluid during the pregnancy compared with values of L/S ratio

Non-invasive respiratory support and preterm infants: The crucial role of nurse management

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