Clinical and laboratory trends in fetal lung maturity testing.
BACKGROUND
The surfactant/albumin ratio is a popular fetal lung maturity (FLM) test that will be unavailable in the near future. We conducted surveys of obstetricians and clinical laboratorians to assess FLM testing trends from the perspectives of both disciplines and to identify how both communities might adapt to the loss of the surfactant/albumin ratio.


METHODS
2067 physicians were surveyed about their familiarity with and clinical utility of various FLM tests. 6137 laboratorians were surveyed about their FLM test menu and volumes.


RESULTS
Twenty-five percent of physicians indicated a decrease in FLM test ordering and the frequency of FLM testing has decreased significantly (p=0.011) since 1998. The surfactant/albumin ratio is the most frequently offered FLM test and was the test of choice for 62% of physicians. Without the surfactant/albumin ratio, 68% of physicians would order the lecithin/sphingomyelin ratio and 44% would order the lamellar body count (LBC) which were offered by 18 and 13% of laboratories, respectively. 16% of laboratories were planning to offer the LBC within 24 months.


CONCLUSIONS
FLM testing is decreasing. The loss of the surfactant/albumin ratio will increase the demand for the lecithin/sphingomyelin ratio and the LBC, yet few laboratories offer either test and most are not planning to offer the LBC.
Grenache
David G
DG
Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT, USA. david.grenache@path.utah.edu
Wilson
Andrew R
AR
Gross
Gilad A
GA
Gronowski
Ann M
AM
D000418:Albumins / Q000032:analysis; D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data* / Q000639:trends*; D003625:Data Collection; D005325:Fetal Organ Maturity; D006801:Humans; D007231:Infant, Newborn; D054709:Lecithins / Q000032:analysis; D010818:Practice Patterns, Physicians'; D011663:Pulmonary Surfactants / Q000032:analysis; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis*; D013109:Sphingomyelins / Q000032:analysis
D000418:Albumins; D054709:Lecithins; D011663:Pulmonary Surfactants; D013109:Sphingomyelins