Amniotic fluid phospholipid profile in multiple pregnancy and the effect of zygosity

Abstract

Because respiratory distress syndrome (RDS) may occur in one twin but not the other it may be misleading to assess fetal lung maturity using amniotic fluid from only one sac. We compared the amniotic fluid lecithin/sphingomyelin (L/S), phosphatidyl glycerol/sphingomyelin (PG/S) and phosphatidyl inositol/sphingomyelin (PI/S) ratios between cotwins and co-triplets in 32 sets of twins and three set of triplets. In the twin pregnancies we found a weak correlation for L/S ratio but a much improved one for PG/S and PI/S. The concordance between sacs for all three ratios was better in monozygotic than in dizygotic twins. The efficacy of amniotic fluid PG in the determination of fetal lung maturity was demonstrated and the discrepancies between the sacs was much less for

Concordance of the risk of neonatal respiratory morbidity assessed by quantitative ultrasound lung texture analysis in fetuses of twin pregnancies

“…They found a weak correlation for L/S ratio but a much-improved correlation for PG/S and PI/S. Concordance was greater in monochorionic pregnancies 1 . In a large study of 132 dichorionic and 125 monochorionic twins, Tsuda et al examined the amniotic lamellar body count (LBC) and found that the concordance of the LBC results for the cut- off value was also significantly lower in dichorionic than in monochorionic twins 27 .…”

“…Discordant neonatal respiratory morbidity (NRM), such as respiratory distress syndrome (RDS) has been described in twin pregnancies 1 . There is always clinical concern that fetal lung maturity (FLM) may differ between twins.…”