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Re: Fetal lung maturityFrom: DuboseTerryJ@uams.eduWed Jul 11 17:17:35 2001
Dr. D'Angelo, here is another article that is looking at another method... Indirect prediction of fetal lung maturity. Value of ultrasonographic colonic and placental grading. J Reprod Med 1998 Oct;43(10):898-902 (ISSN: 0024-7758) Loret de Mola JR; Judge N; Entsminger C; De Viney M; Muise KL; Duchon MA Department of Reproductive Biology, Case Western Reserve University, Cleveland, OH 44106, USA. rlm6@po.cwru.edu. OBJECTIVE: To correlate fetal morphometrics with studies of fetal lung maturity. STUDY DESIGN: One hundred six patients undergoing amniocentesis for fetal lung maturity studies were examined prospectively. Eighty-four patients were normal (79%), and 22 were diabetic (21%). Fetal morphometrics were obtained prior to amniocentesis. The fetal colon and placenta were graded. Discriminant analysis was used to identify variables that were predictive of a mature lecithin/sphingomyelin ratio and the presence of phosphatidylglycerol (PG). All patients delivered within 48 hours of amniocentesis. RESULTS: In the normal group, 28 (33%) fetuses had a grade 3 colon, which was 68% sensitive and 98% specific for a mature amniocentesis. A grade 3 colon was the single best predictor of a mature amniocentesis (P < .001). Twenty-five (29%) fetuses had a grade 3 placenta, which was 64% sensitive and 96% specific for a mature amniocentesis (P < .005). Diabetes did not influence colonic grading since a grade 3 colon was present in seven (32%) patients (47% sensitivity and 100% specificity for PG) (P < .02). Interexaminer and intraexaminer variability for the study was excellent, kappa = 1.0 (P < .001). CONCLUSION: Colonic and placental stage 3 grading are reliable and reproducible ultrasonographic scales that can help predict the findings of fetal lung maturity studies. You might want to try a search of http://www.obgyn.net/medline.asp but I really don't think anyone has a good answer to your question yet. Peace, Terry J. DuBose, M.S., RDMS, APS Assistant Professor & Director, Diagnostic Medical Sonography Program CHRP, University of Arkansas for Medical Sciences Little Rock, Arkansas, USA 501-686-6510 http://www.io.com/~dubose/ http://www.uams.edu/CHRP/dmshome.htm http://www.obgyn.net/us/panel/panel.htm -----Original Message----- From: Pablo D'Angelo [mailto:pjd@post.com] Sent: Wednesday, July 11, 2001 3:26 PM To: Multiple recipients of list ULTRASOUND Subject: Fetal lung madurity Hello Someone knows if there is any RELIABLE way to determine fetal lung madurity with ultrasound? We had a pregnant woman 26 weeks of gestation with premature rupture of membranes from 4 weeks ago, with an AFI that never exceeded 10 mm. We need to know lung madurity. Any idea? Thanks
-- Pablo D'Angelo, MD from Argentina
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