Original Article

The Pattern of Change in the Lecithin/Sphingomyelin Ratio in Patients With Preterm Premature Rupture of Membranes Between 24 and 34 Weeks' Gestation

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Louisville, Louisville, KY, USA

Correspondence to: Helen Y. How, MD, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0526, USA

Abstract

OBJECTIVE: To report the pattern of change in the lecithin/sphingomyelin (L/S) ratio in patients with preterm premature rupture of membranes (PPROM) between 24 and 34 weeks' gestation.

STUDY DESIGN: L/S was determined prospectively using transvaginally and transabdominally collected amniotic fluid from patients with PPROM between 24 and 34 weeks' gestation. Samples were collected prospectively on admission and every 48 to 96 hours until L/S was 2.0. All patients received intramuscular betamethasone weekly.

RESULTS: Fifty-five patients were included in the study. One hundred twenty-seven samples were collected transvaginally and nine were collected transabdominally. Cox regression analysis showed that a higher initial L/S value and more advanced gestational age were associated with accelerated lung maturation. Among patients at 29 weeks' gestation with an initial L/S of 1.5 and <2.0 (n=17), 15 of 17 (88%) reached L/S2 at a mean of 3.1±1.7 days (range 1.0 to 7.0 days). With an initial L/S of 1.0 and <1.5 (n=16), 14 of 16 (88%) patients reached L/S2 at a mean of 4.1±1.9 days (range 1.7 to 7.0 days). With an initial L/S of <1.0 (n=11), 6 of 11 (54%) patients reached L/S2 at a mean of 5.0±1.6 days (range 4.7 to 6.8 days).

CONCLUSION: Our data document a dramatic acceleration of fetal lung maturation among patients with PPROM at 29 weeks. Journal of Perinatology (2002) 22, 21-25 DOI: 10.1038/sj/jp/7210579

January 2002, Volume 22, Number 1, Pages 21-25

Table of contents    Previous  Abstract  Next   Full text  PDF