title: Performance of lecithin-sphingomyelin ratio as a reflex test for documenting fetal lung maturity in late preterm and term fetuses.
abstract: OBJECTIVE
  To determine if infants delivered after immature or indeterminate TDx-FLM II testing and a mature reflex test are at increased risk for neonatal respiratory complications.
  
  
  METHODS
  The primary analysis compared neonatal respiratory morbidity (RDS or TTN) in 34-39-week fetuses delivered after either (i) mature TDx-FLM II testing, or (ii) indeterminate or immature TDx-FLM II and a positive reflex test (PG or L/S ratio).
  
  
  RESULTS
  Fifty patients delivered after mature TDx-FLM II, and 30 after immature or indeterminate TDx-FLM II with an L/S ≥ 2.0. Respiratory morbidity was significantly higher in the group delivered after mature reflex testing compared with mature TDx-FLM II (23% vs. 2%, p < 0.01). When PG was present, there were no cases of RDS or TTN.
  
  
  CONCLUSIONS
  Utilizing L/S ratios as a reflex test to confirm lung maturity was associated with a high risk for respiratory morbidity, particularly when PG was not present.
authors.affiliation: Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Corina
authors.initials: C
authors.lastname: Tennant
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Friedman
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Pare
authors.forename: Christie
authors.initials: C
authors.lastname: Bruno
authors.forename: Eileen
authors.initials: E
authors.lastname: Wang
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry / Q000378:metabolism; D005260:Female; D005325:Fetal Organ Maturity / Q000502:physiology; D005333:Fetus / Q000378:metabolism / Q000502:physiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D054709:Lecithins / Q000032:analysis* / Q000378:metabolism; D011237:Predictive Value of Tests; D011247:Pregnancy; D047928:Premature Birth / Q000175:diagnosis / Q000378:metabolism; D011296:Prenatal Diagnosis / Q000379:methods*; D011379:Prognosis; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis* / Q000378:metabolism; D012189:Retrospective Studies; D013109:Sphingomyelins / Q000032:analysis* / Q000378:metabolism; D047929:Term Birth / Q000378:metabolism; D055815:Young Adult
chemical_list: D054709:Lecithins; D013109:Sphingomyelins