Management of preterm premature rupture of membranes: assessing amniotic fluid in the vagina for phosphatidylglycerol.
This prospective study evaluates the clinical practicality of assessing free amniotic fluid in instances of premature rupture of the membranes (PROM) before term. The presence of phosphatidylglycerol (PG) provided evidence of fetal pulmonary maturity. Daily aspirations of vaginally pooled amniotic fluid were performed on 55 consecutive patients with preterm PROM and met with a success rate of 80% (79 of 99 attempts). Respiratory distress syndrome (RDS) occurred in none of 28 neonates in whom PG was present prior to delivery, and in four of 19 in whom PG was absent. Evidence of surfactant maturation at the time of initial sampling was noticed in 24% of fetuses at 28 to 34 weeks' gestation. Those who initially lacked PG showed an acceleration of its appearance in the aminotic fluid with time, and almost all required a minimum of 48 to 72 hours. Sampling free amniotic fluid for PG is reliable, noninvasive procedure which can be usefully applied to the management of preterm PROm.
D000328:Adult; D000653:Amniotic Fluid / Q000032:analysis*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D005325:Fetal Organ Maturity; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008168:Lung; D010715:Phosphatidylglycerols / Q000032:analysis*; D011247:Pregnancy; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control*
D010715:Phosphatidylglycerols