Yañez E, Izquierdo J C, Yañez L, Chagoya V, Arias F, García Alonso A
Ginecol Obstet Mex. 1998 Nov;66:469-73.
The Diabetes Mellitus is the pathology that frequently is associated to the pregnancy and it is responsible for perinatal mobility specially by the respiratory distress syndrome since exists delay in the conversion of myoinositol-phosphatidyl inositol-phosphatidyl glycerol. To demonstrate the reliability of the DO tho 650 nm with standard of 20 in the determination of fetal lung maturity of the infant of diabetic mother. There were included 143 patient with pregnancy > or = 37 weeks with amenorrhea reliable and gestational age confirmed by ultrasound, of those 94 corresponded to gestational Diabetes Mellitus, 49 to pregestational (46 non insulin-dependent and 3 insulin-dependent). In all of them amniotic fluid studies was perform at 37 week and the resolution of the pregnancy was when DO to 650 nm showed fetal lung maturity. It was found a correlation among the DO to 650 nm of 20 and absence of RDS in 130 cases (true positive); there were seven cases with immaturity results by DO that they did not express RDS (false negative) and six cases with results that showed immaturity by DO and there were manifestations of RDS (true negative). We did not find results of false positive. The frequency of RDS was of 4.9% with a positive predictive value of the 100% an negative predictive value of 46%, a specificity of 100% and a sensitivity of 94%. An interesting finding was the fact that six cases true negative cases had poor maternal metabolic control of different degrees. For our results can be deduced that DO to 650 nm with standard of .20 it is reliable for the diagnosis of fetal lung maturity in the pregnancies complicated with Diabetes Mellitus, in addition to be an easy elaboration test and low cost.
糖尿病是一种常与妊娠相关的病理状态,它是围产期发病率升高的原因,尤其是呼吸窘迫综合征,因为存在肌醇磷脂-磷脂酰肌醇-磷脂酰甘油转化延迟的情况。为了证明在确定糖尿病母亲婴儿的胎儿肺成熟度时,以20为标准的650nm光密度(DO)的可靠性。研究纳入了143例妊娠≥37周、闭经可靠且经超声确认孕周的患者,其中94例为妊娠期糖尿病,49例为孕前糖尿病(46例非胰岛素依赖型和3例胰岛素依赖型)。所有患者均在37周时进行羊水研究,当650nm光密度显示胎儿肺成熟时终止妊娠。结果发现,在130例病例中,650nm光密度为20与无呼吸窘迫综合征(RDS)之间存在相关性(真阳性);有7例光密度结果不成熟但未出现RDS(假阴性),6例光密度结果显示不成熟且出现了RDS(真阴性)。未发现假阳性结果。RDS的发生率为4.9%,阳性预测值为100%,阴性预测值为46%,特异性为100%,敏感性为94%。一个有趣的发现是,6例假阴性病例的母亲代谢控制程度不同。从我们的结果可以推断,以20为标准的650nm光密度对于诊断合并糖尿病的妊娠中的胎儿肺成熟度是可靠的,此外,它是一种易于操作且成本低廉的检测方法。