Amniotic fluid total phospholipids versus lecithin/sphingomyelin ratio in the evaluation of fetal lung maturity

Schreyer, Peter; Tamir, I; Bukovsky, Ian; Weinraub, Z.; Caspi, Eliahu

doi:10.1016/0002-9378(74)90338-x

Cited by 16 publications

(4 citation statements)

References 13 publications

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“…Despite the fact that the rat has been one of the species most widely used for experiments dealing with normal and pathological processes of lung development, a precise analysis of biochemical changes occurring during late gestation and the first days of extrauterine life is not available. Only partial evaluations of short periods have been reported [1][2][3][4], and perhaps be cause of the small fetal size in that species, changes in the surfactant compartment have not been documented except for a recent compositional analysis by Egberts and Noort [5], By contrast, the time-course of lung mat uration is much better documented in other species including rabbits [6][7][8], sheep [9], chickens [10,11], monkeys [12][13][14] and, al though by more indirect approaches, in hu mans [15,16]. These species show markedly increased fetal lung phosphatidylcholine (PC) and disaturated phosphatidylcholine (DSPC) concentration during late gestation; however, more modest changes have been reported for rats, including very little in crease in the percentage of DSPC found in whole lung tissue [2].…”

Section: Introductionmentioning

confidence: 99%

Biochemical Maturation of Fetal Rat Lung: A Comprehensive Study Including Surfactant Determination

et al. 1987

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The paper describes a comprehensive assessment of lung growth and biochemical maturation in the fetal and early postnatal rat. Fetal lung grew faster than whole body between gestational day 16.5 and term. Cell number increased quasi-exponentially, except for a slowing of cell growth between days 19.5 and 20.5 of gestation. By contrast, growth was limited during the two first postnatal days. Percentage of dry tissue and protein concentration increased in parallel during the whole period. Increases in whole lung tissue phosphatidylcholine were greatest between 20.5 and 21.5 days of gestation, whereas in isolated surfactant fraction, changes were most marked between 19.5 and 20.5 days. The most striking changes were a 19-fold increase in phosphatidylcholine and a 12.5-fold increase in the total phospholipid concentrations in the surfactant fraction between gestational day 19.5 and 1 day postpartum. Similar changes occurred in disaturated phosphatidylcholine (DSPC) concentration. During the same period, phospholipids of the residual (nonsurfactant) fraction increased only about 2-fold. These data indicate that analysis of an isolated surfactant fraction is advantageous in providing a very sensitive index of augmented phospholipid production during the process of fetal lung maturation. Evidence of biochemical maturation was detected earlier in females than in males, as indicated by a significantly larger surfactant fraction DSPC concentration in 19.5-day-old females; however, this difference was modest in degree and very transient, since it was no longer demonstrable in later stages.

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Section: Introductionmentioning

confidence: 99%

Biochemical Maturation of Fetal Rat Lung: A Comprehensive Study Including Surfactant Determination

et al. 1987

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“…3). In contrast, all of the 43 infants delivered within two days of amniocentesis with lamellar body phospholipid values greater than 3 mgjdl were free from serious respiratory prob- viously reported by others (Bhagwanani et al, 1972;Nelson, 1972;Gluck and Kulovich, 1973;Nelson and Lawson, 1973;Roux et al, 1973;Schreyer et al, 1974;Ogawa et al, 1976). The rapid release of lungderived phospholipid into the amniotic fluid seems to be an indication that certain critical maturation events have occurred in the fetal lung (Gluck et al, 1974).…”

Section: Resultsmentioning

confidence: 84%

“…The relationship between low lamellar body phospholipid values and the incidence of serious respiratory problems in the newborn suggests that the concentration of lamellar body phospholipid in the amniotic fluid may be a clinically useful parameter. The concentrations of total phospholipid and of lecithin in amniotic fluid have been used to assess fetal lung maturity (Bhagwanani et al, 1972;Nelson, 1972;Nelson and Lawson, 1973;Schreyer et al, 1974). However, these parameters suffer from lack of specificity, since phospholipids (including lecithin) from sources other than the lung may be present in amniotic fluid in highly variable amounts (Fig.…”

Section: Resultsmentioning

confidence: 99%

Lamellar Body Phospholipid Content of Amniotic Fluid: A Possible Index of Fetal Lung Maturity

Duck-Chong

1979

Ann Clin Biochem

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SUMMARYLamellar bodies, produced by secretory cells in the alveolar epithelium, are the major source of surfactant phospholipid. As the fetal lung matures, the membranous content of the lamellar bodies is secreted into the alveolar spaces and passes into the amniotic fluid, from which it can be isolated in a morphologically recognisable form. A method is described for the rapid isolation of a lamellar body fraction from amniotic fluid using a small air-driven clinical ultracentrifuge. The lamellar body phospholipid content of amniotic fluid increases towards the end of gestation, but the time of onset and the rate of this increase show wide individual variation. Preliminary results suggest that the lamellar body phospholipid content of amniotic fluid may be a useful index of fetal lung maturity.

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“…Total phospholipid or palmitic acid concentration also has been proposed similarly [132,169,187,195]. Regarding accuracy and technical simplicity these methods offer no advantages over the L/S ratio.…”

Section: Lecithin Total Phosphorus Palmitic Acidmentioning

confidence: 99%

Review article

1977

Journal of Perinatal Medicine

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Most lifelong neurologic damage originales during the perinatal period. The major cause is asphyxia that almost always is preventable. Among diseases causing neonatal asphyxia, the respiratory distress syndrome (RDS) resulted in 10-15% of perinatal and 20-35% of neonatal deaths [129, 150]. The incidence of neurological handicaps in children surviving severe RDS was many times higher than in the normal population. The prime factor predisposing to perinatal mortality äs well äs RDS is prematurity. More than 90% of fatal cases of RDS were less than 35 weeks gestation, whereas term infants get RDS only occasionally. The estimated overall incidence of RDS in infants weighing less than 2500 gm is about 14% [48]. Perinatal asphyxia and asphyxia at birth are other significant factors increasing the incidence and severity of RDS [15,38,96,159]. Elective cesarean section when performed without proper assessment of the functional maturity of the fetus offers a significant risk for RDS [15,27,55,92,146,181,194]. Finally, the influence of maternal disorders to fetal well being is being appreciated increasingly.Diabetes A and B, particularly when poorly controlled, delays the functional maturity of the lungs [68,158]. RDS hasa characteristic course "beginning" within hours of birth and Clearing within one to two weeks unless fatal or there is chronic lung disease. It can be distinguished from other respiratory disorders such äs meconium aspiration syndrome, infection, congenital anomalies and type II RDS by its typical history and course, characteristic x-ray fmdings, and blood gas analyses indicating shunting of blood from the venous to the arterial System without oxygenation. During the last several years new approaches to therapy such äs intensive care nurseries, regionalization of perinatal care, fetal monitoring and specific treatments, including continuous positive pressure distension of the airways [80] and mechanical Ventilation [51,155] have improved the prognosis both for mortality and neurological sequelae.

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Amniotic fluid total phospholipids versus lecithin/sphingomyelin ratio in the evaluation of fetal lung maturity

Cited by 16 publications

References 13 publications

Biochemical Maturation of Fetal Rat Lung: A Comprehensive Study Including Surfactant Determination

Biochemical Maturation of Fetal Rat Lung: A Comprehensive Study Including Surfactant Determination

Lamellar Body Phospholipid Content of Amniotic Fluid: A Possible Index of Fetal Lung Maturity

Review article

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