Saad S A, Fadel H E, Fahmy K, Nelson G H, Moustafa M, Davis H C
Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta 30912.
Am J Obstet Gynecol. 1987 Dec;157(6):1516-20. doi: 10.1016/s0002-9378(87)80253-3.
Lecithin phosphorus concentration, the standard fetal lung maturity test in our institution, and phosphatidylglyercol were assayed in 69, 29, and 45 amniotic fluid samples from normal (GI), gestational (GII), and insulin-dependent diabetic (GIII) women by means of thin layer chromatography and Amniostat-FLM, respectively. Lecithin phosphorus concentration greater than or equal to 0.1 mg/dl and positive or strong positive Amniostat-FLM results were considered mature. The results of both assays were concordant in 79% of the samples. The discordance rate was highest in GIII patients. In our experience, respiratory distress syndrome did not develop in neonate infants of diabetic women delivered after a mature lecithin result. With lecithin phosphorus concentration as the reference standard, the predictive value of a mature Amniostat-FLM result was 96.2%, whereas that of an immature result was 58.5%. Respiratory distress syndrome occurred in only two GIII neonates who were delivered within 72 hours of both immature lecithin and Amniostat-FLM results. These findings support the use of Aminostat-FLM as a screening test for fetal lung maturity in both normal and diabetic pregnancies. Additional tests will be necessary to evaluate further fetal lung maturity only if the results are negative.
在我们机构，采用薄层色谱法和羊水振荡试验仪（Amniostat-FLM）分别对69例正常孕妇（GI组）、29例妊娠糖尿病孕妇（GII组）和45例胰岛素依赖型糖尿病孕妇（GIII组）的羊水样本进行卵磷脂磷浓度（我们机构标准的胎儿肺成熟度检测指标）及磷脂酰甘油检测。卵磷脂磷浓度大于或等于0.1mg/dl且羊水振荡试验仪结果为阳性或强阳性被视为成熟。两种检测结果在79%的样本中一致。GIII组患者的不一致率最高。根据我们的经验，在卵磷脂结果成熟后分娩的糖尿病孕妇的新生儿未发生呼吸窘迫综合征。以卵磷脂磷浓度作为参考标准，羊水振荡试验仪结果成熟的预测值为96.2%，而结果不成熟的预测值为58.5%。仅在卵磷脂和羊水振荡试验仪结果均不成熟的情况下于72小时内分娩的两名GIII组新生儿发生了呼吸窘迫综合征。这些发现支持将羊水振荡试验仪用作正常和糖尿病妊娠中胎儿肺成熟度的筛查试验。仅当结果为阴性时才需要进行额外检测以进一步评估胎儿肺成熟度。
