Early diagnosis of respiratory distress in premature infants. Application of the Clements test to the gastric fluid

: The stomach of the newborn infant contains swallowed amniotic fluid. The gastric fluid of 66 newborn infants was placed in contact with alcohol, following the technique reported by Clements in relation to amniotic fluid. The stability of the bubbles formed after mixing correspond to the presence of surfactant. In the case of respiratory distress in a premature infant, a positive test is in favour of transient respiratory distress. Intermediate or negative results are seen essentially in the presence of idiopathic respiratory distress. Application of the Clements test to gastric fluid collected immediately after birth is an excellent mean of diagnostic orientation in the presence of early respiratory problems in a premature infant. When negative, the child should be transferred to a specialised centre in order that intermittent positive pressure therapy may be started, the effectiveness of the latter being related to how soon it is begun.