Salzer H, Husslein P, Martin G
Wien Klin Wochenschr. 1980 Aug 29;92(16):578-82.
For the prediction of fetal lung maturity the palmitin stearic acid quotient (P/S ratio) was obtained by amniocentesis from 83 amniotic fluid samples of normal pregnancies, between the 28th and 40th week of pregnancy. This ratio was compared with the surface characteristics of the amniotic fluid in the Wilhelmy balance. A significant correlation was established between these two methods (correlation ellipsis r = 0.82, p < 0.01). The P/S ratio curve showed a marked increase during the 32nd and 36th week of pregnancy, indicating lung maturity. The P/S > 3 value usually reached during the 35th week of pregnancy indicates lung maturity. During the same time amniotic fluid samples were also obtained by amniocentesis from 37 complicated pregnancies. The surface tension as well as the P/S ratio were compared with the already established normal curves. A deceleration was found in cases of rhesusincompatibility and diabetes mellitus. In patients with EPH-gestosis and placental insufficiency only a slight acceleration towards the end of pregnancy was observed. Statistical proof of these trends was not feasible due to the limited number of patients in each group. Comparing the two methods regarding the predictability of pulmonary function in infants, the P/S ratio showed a larger number of false positive findings than the surface tension measurement method. Both methods produced an equal number of false negatives. Optimum results can be obtained by combining P/S ratio and surface tension measurements. This procedure is prognostically accurate in more than 96% of all cases.
为预测胎儿肺成熟度,在妊娠第28周至40周期间,通过羊膜穿刺术从83例正常妊娠的羊水样本中获取棕榈酸硬脂酸商(P/S比值)。将该比值与威尔海姆天平中羊水的表面特性进行比较。这两种方法之间建立了显著相关性(相关系数r = 0.82,p < 0.01)。P/S比值曲线在妊娠第32周和第36周期间显示出显著增加,表明肺成熟。妊娠第35周通常达到的P/S > 3值表明肺成熟。同时,也通过羊膜穿刺术从37例复杂妊娠中获取羊水样本。将表面张力以及P/S比值与已建立的正常曲线进行比较。在恒河猴血型不合和糖尿病病例中发现有减速情况。在妊娠高血压综合征和胎盘功能不全的患者中,仅在妊娠末期观察到轻微加速。由于每组患者数量有限,无法对这些趋势进行统计学验证。在比较这两种方法对婴儿肺功能的预测能力时,P/S比值的假阳性结果比表面张力测量法更多。两种方法产生的假阴性结果数量相同。通过结合P/S比值和表面张力测量可获得最佳结果。在所有病例中,该程序的预后准确率超过96%。