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  • Title: Lecithin-spingomyelin ratio in amniotic fluid for determination of the optimal time of termination of pregnancy.
    Author: Verder H, Felbo M, Fonseca G, Hancke S, Jørgensen PI, Larsen JF, Vang N.
    Journal: Dan Med Bull; 1978 Oct; 25(5):212-7. PubMed ID: 699637.
    Abstract:
    Lecithin/sphingomyelin ratio (L/S), as a tool for determining optimal labor induction and elective ceasarean section time, assesses the pulmonary maturity of the fetus to avoid newborn idiopathic respiratory disease syndrome (IRDS). To decide time of pregnancy termination, amniocentesis was performed and L/S assayed. If L/S was 2.1 induction or surgery was begun, assuming fetal pulmonary maturity; if 2.1 procedures were postponed. In 17/76 cases, the initial L/S was 2.1; in 8 of these cases L/S 2.1 was demonstrated 18-36 days after amniocentesis, and only 1 child developed IRDS. In 5 cases termination was delayed 5 or 6 days, and none of these children developed IRDS. In only 3 cases with primary low L/S values and no chance to delay delivery more than a few days were L/S values below 2 at birth. All 3 children developed IRDS. 2 cases with borderline L/S did not develop IRDS. In 56 cases L/S was higher than 2.1 and pregnancy was terminated; 3 of these infants developed IRDS, but these cases could not have been avoided by using the L/S method. A total of 7 children developed the syndrome (9.1%), 6 moderately and 1 severely. In cases where pregnancy termination could not be postponed, methylprednisolone was injected in uteri to accelerate fetal pulmonary maturity.
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