Fetal lung maturity tests

TABLE 54-6 Number of Laboratories Performing Fetal Lung Maturity Testing, by Method College of American... 

Surfactant proteins (SP-A and SP-B) have been evaluated as potential fetal lung maturity tests, but the results are disappointing. ... 

Many laboratories used a commercial version of this test, called Lumadex, FSI Fetal Lung Maturity Test (Beckman Instruments, Fullerton, Calif.), which was introduced in 1982. Beckman Instruments discontinued this test in 1997. The procedure is described on the Evolve site that accompanies this book. 

Ashwood ER, Palmer SE, Lenke RR. Rapid fetal lung maturity testing commercial versus NBD-phosphatidylcholine assay. Obstet Gynecol 4992 81 1048-53. 

Ashwood ER, Palmer SE, Taylor JS, Pingree SS. LameEar body counts for rapid fetal lung maturity testing. Obstet Gynecol 1993 81 619-24,... 

Dalence CR, Bowie LJ, Dohnal JC, Farrell EE, Neerhof MG. Amniotic fluid lamellar body count a rapid and reliable fetal lung maturity test. Obstet Gynecol 1995 86 235-9. 

Greenspoon JS, Rosen DJ, Roll K, Dubin SB. Evaluation of lamellar body number density as the initial assessment in a fetal lung maturity test cascade. J Reprod Med 1995 40 260-6. 

Wong SS, Schenkel O, Qutishat A. Strategic utilization of fetal lung maturity tests. Scand J Cfin Lab Invest 1996 56 525-32. 

The technique of amniocentesis is described in Ghapter 2. Additional information can be found in the section on tests for evaluating fetal lung maturity later in this chapter. 

In this section of the chapter, we review methods for measurements of CG, AFP, UE3, DIA, fetal fibronectin, and amniotic fluid bihrubin, and six tests for fetal lung maturity. 

Ashwood ER, Markers of fetal lung maturity. In Gronowski AM, ed. Handbook of clinical laboratory testing during pregnancy. Totowa, NJ Humana Press, 2004 55-70. 

Lockitch G, Wittmann BK, Snow BE, Campbell DJ. Prediction of fetal lung maturity by use of the Lumadex-FSI test. Clin Chem 1986 32 361-3. 

Russell JC, Cooper CM, Ketchum CH, Torday JS, Richardson DK, Holt JA, et al. Multicenter evaluation of TDx test for assessing fetal lung maturity, Clin Chem 1989 35 1005-10. 

Sher G, Statland BE, Freer DE, Kraybill EN. Assessing fetal lung maturation by the foam stability index test. Obstet Gynecol 1978 52 673-7. 

SpeUacy WN, Buhi WC, Cruz AC, Gelman SR, Kellner KR, Birk SA. Assessment of fetal lung maturity a comparison of the lecithin/sphingomyelin ratio and the tests of optical density at 400 and 650 nm. Am J Obstet Gynecol 1979 134 528-31. 

Steinfeld JD, Samuels P, BuUey MA, Cohen AW, Goodman DB, Senior MB. The utility of the TDx test in the assessment of fetal lung maturity. Obstet Gynecol 1992 79 460-4. 

Tsai MY, Shultz EK, Williams PP, Bendel R, Butler J, Farb H, et al. Assay of disaturated phosphatidylcholine in amniotic fluid as a test of fetal lung maturity experience with 2000 analyses. CUn Chem 1987 33 1648-51. 

Pulmonary surfactant in amniotic fluid can also be measured by its ability to generate stable foam in the presence of ethanol. This/oam stability test (FST), or shake test, correlates well with the L/S ratio and with fetal lung maturity. In some instances, in the presence of an L/S ratio of less than 2, the FST has indicated lung maturity (without subsequent respiratory distress). This discrepancy may be due to the presence of surfactants other than lecithin that stabilize the neonatal alveoli, namely, phosphatidyl-glycerol (PG) and phosphatidylinositol (PI). These acidic phospholipids are synthesized in stepwise fashion during the last trimester of normal pregnancy. 

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