Indirect prediction of fetal lung maturity. Value of ultrasonographic colonic and placental grading.
OBJECTIVE
To correlate fetal morphometrics with studies of fetal lung maturity.


METHODS
One hundred six patients undergoing amniocentesis for fetal lung maturity studies were examined prospectively. Eighty-four patients were normal (79%), and 22 were diabetic (21%). Fetal morphometrics were obtained prior to amniocentesis. The fetal colon and placenta were graded. Discriminant analysis was used to identify variables that were predictive of a mature lecithin/sphingomyelin ratio and the presence of phosphatidylglycerol (PG). All patients delivered within 48 hours of amniocentesis.


RESULTS
In the normal group, 28 (33%) fetuses had a grade 3 colon, which was 68% sensitive and 98% specific for a mature amniocentesis. A grade 3 colon was the single best predictor of a mature amniocentesis (P < .001). Twenty-five (29%) fetuses had a grade 3 placenta, which was 64% sensitive and 96% specific for a mature amniocentesis (P < .005). Diabetes did not influence colonic grading since a grade 3 colon was present in seven (32%) patients (47% sensitivity and 100% specificity for PG) (P < .02). Interexaminer and intraexaminer variability for the study was excellent, kappa = 1.0 (P < .001).


CONCLUSIONS
Colonic and placental stage 3 grading are reliable and reproducible ultrasonographic scales that can help predict the findings of fetal lung maturity studies.
Loret de Mola
J R
JR
Department of Reproductive Biology, Case Western Reserve University, Cleveland, OH 44106, USA. rlm6@po.cwru.edu
Judge
N
N
Entsminger
C
C
DeViney
M
M
Muise
K L
KL
Duchon
M A
MA
D000328:Adult; D000886:Anthropometry; D003106:Colon / Q000000981:diagnostic imaging / Q000196:embryology; D016640:Diabetes, Gestational / Q000150:complications; D005260:Female; D005325:Fetal Organ Maturity; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000196:embryology*; D010920:Placenta / Q000000981:diagnostic imaging / Q000502:physiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D016216:Ultrasonography, Prenatal / Q000379:methods*