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Objective To compare the performance of the lecithin/sphingomyelin ratio and the lamellar body count in the prediction of neonatal respiratory distress syndrome. Design Meta-analysis.Sample Six studies reporting on the performance of both the lecithin/sphingomyelin ratio and the lamellar body count published between January 1966 and August 1999.Methods We performed a computerised MEDLINE search to identify articles published on the subject. For the six selected studies, prevalence of respiratory distress syndrome and sensitivity and speci®city of the tests in the prediction of respiratory distress syndrome were calculated, and overall performance was assessed by constructing summary receiver±operating characteristic curves. Results The constructed summary receiver±operating characteristic curves showed the lamellar body count to perform slightly better than the lecithin/sphingomyelin ratio in the prediction of respiratory distress syndrome (P 0.13).Conclusions Since the lamellar body count can be performed quickly and since it is less expensive than the lecithin/sphingomyelin ratio, we recommend the former as the test of ®rst choice in the assessment of fetal lung maturity.

AbstractsThere was no significant mortality difference between SpO 2 targets overall. There was significant heterogeneity between old and new software on mortality (test for interaction p=0.006).* Using new software, targeting 91-95% increased hospital survival by 7.4% (from 76.8% to 84.2%) versus targeting 85-89% (p=0.0015).** Conclusions Pending the primary outcome of disability free survival at 2 years it appears wise not to target 85-89%. References Background Hypoxic-ischemic encephalopathy due to perinatal hypoxia-induced free radical formation is an important cause of long-term neurodevelopmental disabilities. Allopurinol reduces the formation of free radicals, which potentially limits hypoxia-induced reperfusion damage. With this trial we aimed to assess whether maternal allopurinol treatment during fetal hypoxia would reduce the release of brain-tissue-specific biomarkers associated with neonatal brain damage. Methods We performed a randomized double blind placebo controlled multicenter trial (NCT00189007) studying laboring women at term with imminent fetal hypoxia. Fetal distress was suspected in case of an abnormal fetal heart rate trace, ST-wave abnormalities on fetal ECG or fetal scalp pH<7.20. Women were allocated to