Abstract
A phospholipid profile, the main features of which were the lecithin/sphingomyelin (L/S) ratio and the presence or absence of phosphatidylglycerol (PG), was determined in amniotic fluid from 188 patients. There was a mature profile (L/S ratio of at least 2 . 0 and detectable PG) in 145 patients, including seven insulin-dependent diabetics, and noe of their babies developed respiratory distress syndrome (RDS). The L/S ratio was less than 2 . 0 and PG absent in 12 patients, nine of whose babies developed RDS, whereas only three small babies (delivered between 28 and 35 weeks because of fulminant pre-eclampsia or severe abruptio placentae) out of 31 developed RDS when the L/S ratio was less than 2 . 0 but PG was present. When amniotic fluid was collected from the vagina only one out of 69 babies developed RDS when PG was present (regardless of the L/S ratio), while all of seven babies developed RDS when PG was absent. It is concluded that the amniotic fluid phospholipid profile, particularly the presence or absence of PG, gives an accurate assessment of fetal lung maturation. The profile may prove a useful adjunct to the management of high-risk pregnancies, especially after premature membrane rupture and perhaps also when the mother is diabetic.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Cunningham M. D., Desai N. S., Thompson S. A., Greene J. M. Amniotic fluid phosphatidylglycerol in diabetic pregnancies. Am J Obstet Gynecol. 1978 Aug 1;131(7):719–724. doi: 10.1016/0002-9378(78)90233-8. [DOI] [PubMed] [Google Scholar]
- Gluck L., Kulovich M. V., Borer R. C., Jr, Brenner P. H., Anderson G. G., Spellacy W. N. Diagnosis of the respiratory distress syndrome by amniocentesis. Am J Obstet Gynecol. 1971 Feb 1;109(3):440–445. doi: 10.1016/0002-9378(71)90342-5. [DOI] [PubMed] [Google Scholar]
- Harvey D., Parkinson C. E., Campbell S. Letter: Risk of respiratory-distress syndrome. Lancet. 1975 Jan 4;1(7897):42–42. doi: 10.1016/s0140-6736(75)92407-1. [DOI] [PubMed] [Google Scholar]
- Kulovich M. V., Gluck L. The lung profile. II. Complicated pregnancy. Am J Obstet Gynecol. 1979 Sep 1;135(1):64–70. [PubMed] [Google Scholar]
- Kulovich M. V., Hallman M. B., Gluck L. The lung profile. I. Normal pregnancy. Am J Obstet Gynecol. 1979 Sep 1;135(1):57–63. [PubMed] [Google Scholar]
- Miller J. M., Jr, Pupkin M. J., Crenshaw C., Jr Premature labor and premature rupture of the membranes. Am J Obstet Gynecol. 1978 Sep 1;132(1):1–6. doi: 10.1016/0002-9378(78)90789-5. [DOI] [PubMed] [Google Scholar]
- Wagstaff T. I., Whyley G. A., Freedman G. Factors influencing the measurement of the lecithin sphingomyelin ration in amniotic fluid. J Obstet Gynaecol Br Commonw. 1974 Apr;81(4):264–277. doi: 10.1111/j.1471-0528.1974.tb00458.x. [DOI] [PubMed] [Google Scholar]
- Whittle M. J., Hill C. M. Relation between the amniotic fluid lecithin/sphingomyelin ratio, fetal cord blood corticosteroid levels and the duration of induced labour. Br J Obstet Gynaecol. 1980 Jan;87(1):38–42. doi: 10.1111/j.1471-0528.1980.tb04423.x. [DOI] [PubMed] [Google Scholar]
- de V Graaff J., Gunston K. D. The prediction of fetal pulmonary maturity from amniotic fluid contaminated by vaginal secretion. S Afr Med J. 1978 Dec 30;54(27):1145–1146. [PubMed] [Google Scholar]