Clinical experience with the amniotic fluid lecithin/sphingomyelin ratio

I. Antenatal prediction of pulmonary maturity
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      Amniotic fluid lecithin/sphingomyelin (L/S ratios were measured in 425 pregnancies and restrospectively correlated with neonatal pulmonary performance. L/S ratios of 2.0 and greater, a value reached at about 34 weeks of gestation, were associated with 3.7 per cent morbidity from idiopathic respiratory distress syndrome (RDS) and a 0.3 per cent mortality rate from hyaline membrane disease (HMD) among 347 newborn infants. A 63 per cent morbidity from RDS and 23 per cent mortality rate from HMD, however, were found among 48 newborn infants delivered within 72 hours of having an L/S ratio of less than 2.0. The association of an L/S ratio greater than 2.0 with a low incidence of RDS and virtual absence of HMD substantiates the value of this method as a predictor of fetal pulmonary maturity.
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