Sepúlveda W H, Araneda H, Avendaño A
Servicio de Obstetricia y Ginecología, Hospital Clínico Regional Guillermo Grant Benavente, Universidad de Concepción.
Rev Chil Obstet Ginecol. 1991;56(1):43-7.
The relationship between ultrasonographic detection of fetal vernix and visual assessment of amniotic fluid (AF) and fetal pulmonary maturity evaluated by the "shake test" was studied in 73 high-risk patients undergoing amniocentesis for obstetrical indications. The AF was classified as type I, type II, and type III, depending on the subjective amount of vernix detected. Ultrasound predicted correctly 7 out of 11 cases of type I AF (64%), 14 out of 22 cases of type II AF (64%), and 38 out of 40 cases of type III AF (95%). When ultrasonography detected type I AF the "shake test" was negative in all cases, whereas if type II or type III were found, the "shake test" was positive in 40% and 86%, respectively. Our results suggest that sonographic detection of type I AF is associated with immaturity, thus amniocentesis should be avoided in such cases. Conversely, if a type III AF is detected a mature fetus is found in almost 90% of the cases. The observation of AF detecting fetal vernix during third trimester sonography is a simple manoeuver that can help to avoid the use of amniocentesis, an invasive procedure associated with some serious fetal and maternal complications.
在73例因产科指征接受羊膜穿刺术的高危患者中，研究了超声检测胎儿胎脂与羊水（AF）视觉评估以及通过“摇晃试验”评估的胎儿肺成熟度之间的关系。根据检测到的胎脂主观量，将羊水分为I型、II型和III型。超声正确预测出11例I型羊水病例中的7例（64%）、22例II型羊水病例中的14例（64%）以及40例III型羊水病例中的38例（95%）。当超声检测到I型羊水时，所有病例的“摇晃试验”均为阴性，而如果发现II型或III型羊水，“摇晃试验”的阳性率分别为40%和86%。我们的结果表明，超声检测到I型羊水与不成熟相关，因此在这种情况下应避免进行羊膜穿刺术。相反，如果检测到III型羊水，几乎90%的病例中胎儿是成熟的。在孕晚期超声检查中观察羊水检测胎儿胎脂是一种简单的操作，可以帮助避免使用羊膜穿刺术，这是一种与一些严重胎儿和母体并发症相关的侵入性手术。
