Predicting respiratory distress by thin-layer chromatography of the newborn gastric aspirate.

The analysis of gastric fluid from newborns for lecithin/sphingomyelin (L/S) ratio evaluation is useful in determining whether respiratory distress will follow an early delivery. Without exception, the L/S ratios obtained on 14 gastric aspirates paralleled and were slightly higher than intrapartum values obtained from corresponding amniotic fluids (5.6 vs 3.7). Of 46 normal infants, only 1 had a gastric aspirate L/S ratio less than 2:1. No false positive results were found. The obstetrician can easily obtain gastric fluid at delivery, and by ordering an L/S ratio determination, the neonatologist can have an estimation of lung surfactant levels within 2 hours after birth. In cases where true respiratory distress syndrome (RDS) must be differentiated from other problems of respiratory distress, this information can assist in the early management of patients with RDS. Even after the development of RDS, the procedure offers a prognostic tool which the clinician can use in discussing the outcome with the parents.

Reanastomosis of the previously ligated fallopian tube.

Tubal sterilization procedures are being performed on young women in increasing numbers. For a variety of reasons a small but significant number of women are requesting reversal of the tubal interruption. This report presents a series of 20 consecutive patients on whom tuabl reanastomoses of previously noncoagulated, surgically ligated fallopian tubes were performed. An intraluminal tubal suture technique is described. Low magnification (X2 to X4) was used. The comparative results of the patients operated upon revealed a tubal pregnancy rate of 80%, a total pregnancy rate of 70%, a viable pregnancy rate of 55%, three abortions, and one ectopic pregnancy.

PIP: A series of patients who underwent surgical end-to-end reanastomosis of previously ligated fallopian tubes is presented. The technique was highlighted by use of intraluminal suture under relatively low magnification (times 2 or times 4). Pre-, post-, and operative data are presented tabularly for the 20 women represented in this series. 80% (16 of 20) had patent tubes, and 70% became pregnant (14 of 20); 15% of these aborted and 1 lost her pregnancy to ectopic complication. Therefore, 55% had viable pregnancies. The time interval from ligation to reanastomosis ranged from 5 months - 13 years. The time interval from reanastomosis to pregnancy ranged from 1-31 months (mean 8 months), and reasons for requesting reanastomosis ranged from improved economic status to remarriage.