The lecithin/sphingomyelin ratio in twin pregnancies.

The lecithin/sphingomyelin ratio showed no difference between the two amniotic sacs in 24 multiple pregnancies examined before the onset of labor. Once labor started, however, the L/S ratio was higher in the first sac compared to the second in the six pregnancies where labor had commenced and was somewhat advanced at the time of amniocentesis. Dual-sac amniocentesis is essential during labor when assessment of pulmonary maturity is required, whereas single-sac sampling is adequate before the start of labor.