Fetal lung maturity in complicated pregnancy, as predicted from microviscosity of amniotic fluid.

1982 ◽  
Vol 28 (8) ◽  
pp. 1754-1757 ◽  
Author(s):  
N V Simon ◽  
W A Hohman ◽  
R C Elser ◽  
J S Levisky ◽  
M J Carp ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
Lung Maturation ◽  
Class D ◽  
Hyaline Membrane ◽  
Induced Hypertension ◽  
Complicated Pregnancy ◽  
Fetal Lung Maturation ◽  
Lung Maturity

Abstract We measured the microviscosity of amniotic fluid between 28 and 40 weeks of gestation in 252 normal pregnancies and in 172 pregnancies complicated by factors known to influence fetal lung maturation, including chronic high blood pressure, pregnancy-induced hypertension, diabetes mellitus, and therapy with betamethasone. Comparison of the microviscosity value distributions and regression analysis indicated significantly lower microviscosity values in hypertensive disorders, in Class D and Classes F or R diabetes, and after 48 h of treatment with betamethasone. Few changes were observed in Classes A, B, or C diabetes. These observations are consistent with the accelerated maturation of surfactant observed in chronic intrauterine stress and the lower incidence of hyaline membrane disease reported after glucocorticoids.

Lamellar body phospholipid content of amniotic fluid and L/S ratio compared in assessing fetal lung maturity.

1980 ◽  
Vol 26 (6) ◽  
pp. 766-769 ◽  
Author(s):  
C G Duck-Chong ◽  
J M Gupta ◽  
G N Storey ◽  
C R Houghton
Keyword(s):  
Amniotic Fluid ◽  
Lamellar Body ◽  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
Phospholipid Content ◽  
Human Amniotic Fluid ◽  
Respiratory Problems ◽  
Fetal Lung Maturity ◽  
Hyaline Membrane ◽  
Lung Maturity

Abstract A micro-method has been devised for isolating a lung-derived membranous fraction from human amniotic fluid. The phospholipid content of this fraction, known as lamellar body phospholipid, provides an indication of fetal lung maturity (Ann. Clin. Biochem 16: 191, 1979). This method has now been applied to 479 samples of amniotic fluid from 330 pregnancies. The lecithin/sphingomyelin ratio has also been determined for each of the samples by the routine method currently in use in the hospitals providing the samples. Hyaline membrane disease was associated with a low concentration of lamellar body phospholipid (< 35 mg/L) in all eight cases encountered in this study. In contrast, in 182 of the 185 cases where the lamellar body content of the amniotic fluid, collected within two days of delivery, exceeded 35 mg/L, the infants were free from serious respiratory problems. Data are presented which suggests that the lecithin/sphingomyelin ratio falsely indicated lung immaturity in many cases, amounting to 44% or more of all values indicating immaturity that were reported.

Lamellar body phospholipid content of amniotic fluid and L/S ratio compared in assessing fetal lung maturity.

1980 ◽  
Vol 26 (6) ◽  
pp. 766-769
Author(s):  
C G Duck-Chong ◽  
J M Gupta ◽  
G N Storey ◽  
C R Houghton
Keyword(s):  
Amniotic Fluid ◽  
Lamellar Body ◽  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
Phospholipid Content ◽  
Human Amniotic Fluid ◽  
Respiratory Problems ◽  
Fetal Lung Maturity ◽  
Hyaline Membrane ◽  
Lung Maturity

Abstract A micro-method has been devised for isolating a lung-derived membranous fraction from human amniotic fluid. The phospholipid content of this fraction, known as lamellar body phospholipid, provides an indication of fetal lung maturity (Ann. Clin. Biochem 16: 191, 1979). This method has now been applied to 479 samples of amniotic fluid from 330 pregnancies. The lecithin/sphingomyelin ratio has also been determined for each of the samples by the routine method currently in use in the hospitals providing the samples. Hyaline membrane disease was associated with a low concentration of lamellar body phospholipid (< 35 mg/L) in all eight cases encountered in this study. In contrast, in 182 of the 185 cases where the lamellar body content of the amniotic fluid, collected within two days of delivery, exceeded 35 mg/L, the infants were free from serious respiratory problems. Data are presented which suggests that the lecithin/sphingomyelin ratio falsely indicated lung immaturity in many cases, amounting to 44% or more of all values indicating immaturity that were reported.

Measurement of "lamellar body phospholipid" in amniotic fluid as a method for assessing fetal lung maturity.

1981 ◽  
Vol 27 (11) ◽  
pp. 1851-1855 ◽  
Author(s):  
C G Duck-Chong ◽  
D J Henderson-Smart ◽  
J M Gupta ◽  
W J Hensley
Keyword(s):  
Amniotic Fluid ◽  
Clinical Laboratory ◽  
Lamellar Body ◽  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
Phospholipid Content ◽  
Respiratory Problems ◽  
Hyaline Membrane ◽  
Routine Clinical Laboratory ◽  
Lung Maturity

Abstract A simple, rapid micro-method, suitable for use in a routine clinical laboratory, is described for isolating a surfactant fraction from 0.1 mL of human amniotic fluid and measuring its phospholipid content. We determined the phospholipid content of this fraction, referred to as "lamellar body phospholipid," in 451 samples of amniotic fluid collected within two days of delivery and related the data to the respiratory performance of the newborn in every case; 112 of the infants were delivered at 28-37 weeks gestation. The incidence of hyaline membrane disease was inversely related to the concentration of lamellar body phospholipid in the amniotic fluid. Eleven of 12 infants with lamellar body phospholipid values less than 25 mg/L and four of 44 infants with lamellar phospholipid values between 25 and 50 mg/L developed hyaline membrane disease or other serious respiratory problems possibly related to lung immaturity, whereas all of 395 infants with lamellar body phospholipid values of 50 mg/L or more were free from respiratory problems of this nature. The incidence of transient tachypnea was greatest when the lamellar body phospholipid value was between 25 and 50 mg/L, suggesting that this condition may be related to a degree of lung maturity.

Hyaline membrane disease in black newborns: does fetal lung maturation occur earlier?

1994 ◽  
Vol 55 (3) ◽  
pp. 157-161 ◽  
Author(s):  
Pierre-Yves Robillard ◽  
Thomas C. Hulsey ◽  
Greg R. Alexander ◽  
Marie-Pierre Sergent ◽  
François de Caunes ◽  
...  
Keyword(s):  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
Lung Maturation ◽  
Hyaline Membrane ◽  
Fetal Lung Maturation

Evaluation of the Amniostat-FLM assay for assessment of fetal lung maturity.

1984 ◽  
Vol 30 (7) ◽  
pp. 1233-1237 ◽  
Author(s):  
G Lockitch ◽  
B K Wittmann ◽  
S M Mura ◽  
L C Hawkley
Keyword(s):  
Thin Layer ◽  
Amniotic Fluid ◽  
Screening Method ◽  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
Rapid Screening ◽  
Fetal Lung Maturity ◽  
Shake Test ◽  
Hyaline Membrane ◽  
Lung Maturity

Abstract Results of the "Amniostat-FLM" assay, a rapid semiquantitative test for phosphatidylglycerol, were compared with determinations of the lecithin/sphingomyelin (L/S) ratio, with phosphatidylglycerol measured by two-dimensional thin-layer chromatography, and with results of the "shake test" for 94 specimens of amniotic fluid. Correlation between results with the Amniostat and the other tests was excellent. All four tests are very accurate when predicting lung maturity. The predictive value of a negative test, i.e., that hyaline membrane disease would not occur, was between 92 and 100%. However, the accuracy of predicted lung immaturity is poor. For all four tests, predictions of lung immaturity were incorrect in more than 50% of the cases. Of the 49 infants born within 72 h of testing, none developed hyaline membrane disease when phosphatidylglycerol was detectable by either method or when the shake test indicated fetal lung maturity, but three infants with L/S ratio greater than 2/1 did develop the disease. The Amniostat provides a rapid screening method for detecting phosphatidylglycerol in amniotic fluid, which could well replace the thin-layer chromatographic method for measuring phosphatidylglycerol in the panel of diagnostic tests for fetal lung maturity.

Racial and Environmental Influences on Fetal Lung Maturation

PEDIATRICS ◽  
1981 ◽  
Vol 68 (6) ◽  
pp. 790-795
Author(s):  
Samuel Ross ◽  
Richard L. Naeye
Keyword(s):  
South African ◽  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
The United States ◽  
African Women ◽  
The South ◽  
Lung Maturation ◽  
The Us ◽  
Hyaline Membrane ◽  
Fetal Lung Maturation

Claims that fetal lung maturation is more rapid in blacks than in whites were investigated. Histologic measurements of lung maturation and the frequency of hyaline membrane disease were compared in four groups of neonates: 490 South African blacks, 841 Ethiopians, 767 US blacks, and 560 US whites. Lungs matured much more rapidly in the Ethiopian and more slowly in the South African than in the US fetuses. The rate of maturation was about the same in US blacks and whites. Hyaline membrane disease was more frequent in the South Africans and less frequent in the Ethiopians than in either US group. Environmental factors in the mother may explain some of these differences. Lungs matured more rapidly in the fetuses of cigarette smokers than in fetuses of nonsmokers. Half of the US mothers but almost none of the South African mothers smoked during pregnancy. The rate of lung maturation had an inverse correlation with maternal body weights. The South African women were heavier and the Ethiopians lighter than women in the United States.

The Lecithin-Sphingomyelin Ratio of Amniotic Fluid: An Index of Fetal Lung Maturity?

PEDIATRICS ◽  
1972 ◽  
Vol 49 (3) ◽  
pp. 464-466
Author(s):  
Jacques F. Roux ◽  
Junichi Nakamura ◽  
Edwin Brown ◽  
Avron Y. Sweet
Keyword(s):  
Amniotic Fluid ◽  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
Postnatal Period ◽  
Fetal Lung Maturity ◽  
Hyaline Membrane ◽  
Lung Maturity

The proportion of lecithin (L) to sphingomyelin (S) measured in amniotic fluid has been proposed as an index of fetal lung maturity.1 A ratio of L to S of 1.5 or less has been correlated with hyaline membrane disease in the postnatal period. Therefore, prevention or delay of immediate delivery has been advocated in such circumstances. In our laboratory, the L to S ratio (L/S) was determined immediately before birth in 88 amniotic fluid samples obtained by amniocentesis between the 8th and 46th week of gestation.

Improved procedure for lecithin/sphingomyelin ratio in amniotic fluid reduces false predictions of lung immaturity.

1982 ◽  
Vol 28 (2) ◽  
pp. 344-348 ◽  
Author(s):  
L M Brown ◽  
C G Duck-Chong ◽  
W J Hensley
Keyword(s):  
Amniotic Fluid ◽  
Clinical Performance ◽  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
Hyaline Membrane

Abstract Many laboratories have found that their procedure for determining lecithin/sphingomyelin (L/S)ratios gives an unacceptably high proportion of false predictions of fetal lung immaturity. We investigated each step in the procedure, in an attempt to improve the clinical performance of the test and to make the method more amenable to standardization between laboratories. L/S ratios were determined by the new procedure in amniotic fluid from 147 pregnancies, collected within two days of delivery of the infant. Four cases had an L/S ratio less than 2; all developed hyaline membrane disease. No other cases of hyaline membrane disease were encountered in this study. For 106 of these pregnancies, the L/S ratio was also determined by the procedure previously in use. This predicted lung immaturity for 16 infants, only four of whom developed hyaline membrane disease. All 12 cases incorrectly predicted as immature by the old procedure were correctly classified by the new procedure.

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