European Journal of Biomedical and Pharmaceutical Sciences

PREVALENCE OF HYALINE MEMBRANE DISEASE WITH SPECIAL REFERENCE TO SIGNIFICANCE OF GASTRIC SHAKE TEST IN PRETERM INFANTS

Dr. Keerti Swarnkar*and Dr. Manish Swarnkar

ABSTRACT

Background: The morbidity and mortality of hyaline membrane disease (HMD) are quite high due to delayed diagnosis and intervention. Commonly, HMD occurs in preterm infants with surfactant deficiency because of lung immaturity. The shake test can be used to assess whether surfactant is present in the infant's lungs at birth. Objective: The goal of this study was to determine neonatal maternal risk factors for development of HMD and usefulness and accuracy of gastric aspirate shake test for the diagnosis of HMD. Materials and Methods: This study was a prospective, cross sectional hospital-based study, carried out from January 2003 to October 2004 at kamla Nehru hospital, Gandhi medical college, Bhopal. The inclusion criteria were, gestational age of 25-<37 weeks, Subjects with amniotic fluid contaminated by maternal blood or Meconium were excluded. The shake test was performed using gastric fluid and the results of the shake test were correlated with definitive diagnosis of HMD. Results: In present study out of 419 eligible preterm newborn admitted in NICU, 74(17.66%) developed respiratory distress, out of which 46 cases developed HMD, thus giving rise to overall prevalence of 10.97% and a very high incidence of 62% amongst the cases of Neonatal respiratory distress. HMD was more frequent when gestational age and birth weight were ˂32wks and ˂1700gm (p value˂0.001), male sex cases were predominantly affected and caesarian section associated with high risk of developing HMD (p value˂0.001). Our findings indicated that the gastric aspirate shake test has 100% sensitivity, 82% specificity, a 42.4% positive predictive value and negative predictive value of 100%. Conclusion: According to this study gastric shake test (GST) is a reliable test and is a simple procedure to identify those neonates who will develop respiratory distress syndrome (RDS) and therefore to decide prophylactic exogenous surfactant replacement.

Keywords: Gastric shake test, Hyaline Membrane Disease, Preterm Infants.