title: Sonographic measurements of fetal parts to predict pulmonary maturity among twins and singletons.
abstract: To determine if sonographic examination of fetus can be readily utilized to predict a mature lecithin/sphingomyelin (L/S) ratio among twins and singletons. Twins (n = 36) undergoing amniocentesis for assessment of pulmonary maturity were matched with singleton (1:2) for maternal demographics, gestational age (GA), and indications for procedure. At the time of amniocentesis, twins and singletons with mature L/S ratios differed significantly in mean GA (33.2 +/- 2.7 vs 34.5 +/- 4.6 wks, p = 0.01), biparietal diameter (BPD), abdominal circumference (AC), femur length (FL) and estimate of birth weight (EFW). Based on ten receiver operating characteristics curves constructed, the following diagnostic thresholds predicted a mature L/S ratio with a true positive rate of 100% among twins and singletons, respectively: 1) BPD $84 and $92 mm; 2) head circumference $315 and $320 mm; 3) AC $295 and $350 mm; or 4) FL $64 and $72 mm; or 5) EFW $2400 and $3200 g. Using any one of these five criteria correctly identified pulmonary maturity among 59% of twins and 28% of singletons (p = 0.001). Sonographic measurement of fetal parts or EFW may be a noninvasive method to predict a mature L/S ration among twins as well as singletons.
authors.affiliation: Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Medical College of Georgia, Augusta, USA.
authors.forename: S P
authors.initials: SP
authors.lastname: Chauhan
authors.forename: E F
authors.initials: EF
authors.lastname: Magann
authors.forename: J C
authors.initials: JC
authors.lastname: Morrison
authors.forename: A D
authors.initials: AD
authors.lastname: Gunter
authors.forename: N S
authors.initials: NS
authors.lastname: Whitworth
authors.forename: L D
authors.initials: LD
authors.lastname: Devoe
mesh_terms: D000328:Adult; D001699:Biometry; D005260:Female; D005269:Femur / Q000196:embryology; D005325:Fetal Organ Maturity; D005865:Gestational Age; D006801:Humans; D008168:Lung / Q000196:embryology*; D010713:Phosphatidylcholines / Q000032:analysis; D011247:Pregnancy; D012372:ROC Curve; D013109:Sphingomyelins / Q000032:analysis; D014427:Twins; D016216:Ultrasonography, Prenatal
chemical_list: D010713:Phosphatidylcholines; D013109:Sphingomyelins