Harman C R, Manning F A, Stearns E, Morrison I
Am J Obstet Gynecol. 1982 Aug 15;143(8):941-3. doi: 10.1016/0002-9378(82)90478-1.
In a previous study, it was suggested that the presence of a grade III placenta correlates 100% with a mature lecithin/sphingomyelin (L/S) ratio and may replace amniocentesis in confirming fetal lung maturity. In this study that hypothesis was tested in 563 pregnancies. All patients underwent amniocentesis and simultaneously had placental grading. The correlations of placental grade with an L/S ration greater than or equal to 2 were: grade 0, 17%; grade I, 68%; grade II, 91%. The correlations of placental grade with the presence of phosphatidylglycerol (PG) were: grade 0, 17; grade 1, 41%; grade II, 79%; grade II, 75%. The false positive rates associated with grade III placenta were, therefore, 7% for mature L/S ratio and 25% for PG present: when combined with a biparietal diameter greater than or equal to 9.0 cm, a grade III placenta incorrectly predicted lung maturity in 8.5%. We conclude that placental grading is not accurate enough to replace amniocentesis as the standard test of fetal pulmonary maturity.
在之前的一项研究中，有人提出Ⅲ级胎盘的存在与卵磷脂/鞘磷脂（L/S）比值成熟100%相关，并且在确认胎儿肺成熟方面可能替代羊膜穿刺术。在本研究中，对563例妊娠进行了该假说的验证。所有患者均接受了羊膜穿刺术并同时进行了胎盘分级。胎盘分级与L/S比值大于或等于2的相关性为：0级，17%；Ⅰ级，68%；Ⅱ级，91%。胎盘分级与磷脂酰甘油（PG）存在的相关性为：0级，17%；Ⅰ级，41%；Ⅱ级，79%；Ⅲ级，75%。因此，Ⅲ级胎盘的假阳性率对于成熟L/S比值为7%，对于PG存在为25%：当与双顶径大于或等于9.0 cm相结合时，Ⅲ级胎盘错误预测肺成熟的比例为8.5%。我们得出结论，胎盘分级不够准确，不能替代羊膜穿刺术作为胎儿肺成熟的标准检测方法。
