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PROM Fluids Tested to Assess Lung Maturity

From: C-upi@clari.net (UPI / ED SUSMAN)
Subject: New test can prevent preterm delivery
Organization: Copyright 1997 by United Press International
Date: Thu, 1 May 1997 0:33:46 PDT

LAS VEGAS, May 1 (UPI) -- Orlando researchers say a simple test can help doctors decide if they have to induce labor because a pregnant woman's bag of waters has ruptured.

In a report to the annual meeting of the American College of Obstetricians and Gynecologists in Las Vegas, scientists say fluid remaining in the vagina can be used for tests which tell if the baby is ready avoiding delivery of a child with underdeveloped lungs.

In the United States each year, an estimated 400,000 pregnant women have their water break prior to labor. In as many as 8,000 of these cases, the infant does not have lungs developed enough for the child to survive on his own.

Dr. Stephen Carlan, director of maternal-fetal medicine at Arnold Palmer Hospital for Children and Women in Orlando, says the situation puts doctors in a dilemma: Should they induce delivery or try to give the fetus a few more -- sometimes critical -- days or weeks in the womb?

In order to determine if the baby is ready doctors can test the amniotic fluid from the placenta to determine levels of lung surfactant. Higher levels of surfactant means the baby's lungs have developed well enough and delivery is safe.

``Up to now,'' Carlan says, ``doctors have been unwilling to test fluid still pooled in the vagina because they believe that fluid is contaminated and the results of a test would be meaningless. Our study of 42 women shows that if there is still fluid in the vagina, it is fresh and can give acceptable results which can be used by the doctors to manage patients and the babies.''

Carlan says that if the tests shows sufficient levels of surfactant, he induces labor and delivers the baby. If the surfactant levels are low, the patient is monitored carefully, but the baby stays inside the mother as long as possible.

Carlan notes that if the women begins labor after her water breaks, the doctors has little choice but to deliver the child whether it is nearly full term or still a preterm baby with serious problems.

But, he said, by using the available amniotic fluid to perform the tests on women who haven't yet gone into labor, doctors can give those 8,000 preterm babies a better chance of survival.