Sonographically detected free-floating particles in amniotic fluid predict a mature lecithin–sphingomyelin ratio
✍ Scribed by Thomas L. Gross; Robert N. Wolfson; Paul M. Kuhnert; Robert J. Sokol
- Publisher
- John Wiley and Sons
- Year
- 1985
- Tongue
- English
- Weight
- 533 KB
- Volume
- 13
- Category
- Article
- ISSN
- 0091-2751
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✦ Synopsis
Amniocentesis for the determination of fetal lung maturity is associated with some morbidity, and so the prediction of a mature fetus by noninvasive means could be useful in managing certain high-risk patients. In the first portion of this study, 467 amniotic fluid specimens were classified into one of five groups based on the turbidity and particulate matter present. The mean lecithin : sphingomyelin (L/S) ratios and the proportion of mature U S values increased with increasing turbidity of the amniotic fluid. In the second portion of this study, the presence of amniotic fluid freefloating particles (FFPs) detected by real-time ultrasound was correlated with fetal lung maturity. When FFPs were present, the W S was uniformly mature, but when FFPs were absent, the LIS was mature in 74% of patients (P < 0.01). Among the patients in whom the LIS ratios were mature, 391110 were associated with positive FFPs (sensitivity = 35%). This preliminary study suggests that the presence of FFPs on real-time ultrasound could be used to confirm fetal lung maturity. Indexing Words: Ultrasonography -Amniotic fluid -Vernix -Fetal maturity The determination of fetal lung maturity by measurement of the amniotic fluid lecithin : sphingomyelin (US) ratio is an accepted method of predicting neonatal pulmonary status prenatally. Amniocentesis is associated with some morbidity, including fetal trauma and fetal death,' so the prediction of a mature fetus by noninvasive means could be useful in obstetric management.
Previous studies have evaluated how ultrasound measurements, including fetal biparietal diameter and placental maturational changes, could be used as a screening method to predict fetal pulmonary maturity.'~~ Respiratory distress syndrome (RDS) is quite rare in patients undergoing maturity t e ~t i n g . ~ Since a mature L/S is highly correlated with the absence of RDS, previous studies