Pulmonary phospholipids in amniotic fluid of pathologic pregnancies: relationship with clinical status of the newborn.
We evaluated phospholipids, C-peptide and cortisol levels in amniotic fluid of 203 pathologic pregnancies (63, class A, B and C diabetics; 11 class D, F and H diabetics; 44 preclampsia and 85 Rh-isoimmunization); the control group was 82 normal pregnant women. There was an acceleration of fetal pulmonary maturation in women with preclampsia and severe Rh-isoimmunization in class D, F and H diabetics (at 34 weeks gestation the incidence of mature surfactant (lecithin/sphingomyelin greater than or equal to 2.7 and presence of phosphatidyl-glycerol) in these groups was 30%, 50% and 100%, respectively, while it was zero in the control group). At 37 and 38 weeks only 44.4% of the class A, B and C diabetics had mature surfactant and there was a significant difference with respect to the control group (x2 = 4.9; p less than 0.05); C-peptide levels in these diabetics (class A, B and C) were higher than in controls (p less than 0.001); in pregnant women with accelerated fetal lung maturation they were lower. We demonstrated a close relationship between fetal pulmonary maturity and the type of surfactant in amniotic fluid, which was independent of gestational age.
Zapata
A
A
Biochemistry Service, 'La Paz' Hospital, Madrid Spain.
Hernandez-Garcia
J M
JM
Grande
C
C
Martinez
I
I
Perez
J
J
de la Fuente
P
P
Usandizaga
J A
JA
D000653:Amniotic Fluid / Q000032:analysis*; D002096:C-Peptide / Q000032:analysis; D005260:Female; D005325:Fetal Organ Maturity; D006801:Humans; D006819:Hyaline Membrane Disease / Q000175:diagnosis; D006854:Hydrocortisone / Q000032:analysis; D007231:Infant, Newborn; D008168:Lung / Q000196:embryology; D010713:Phosphatidylcholines / Q000032:analysis; D011225:Pre-Eclampsia / Q000378:metabolism*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000378:metabolism*; D011663:Pulmonary Surfactants / Q000032:analysis*; D012203:Rh Isoimmunization / Q000378:metabolism*; D013109:Sphingomyelins / Q000032:analysis
D002096:C-Peptide; D010713:Phosphatidylcholines; D011663:Pulmonary Surfactants; D013109:Sphingomyelins; D006854:Hydrocortisone