Evaluation of fetal maturity by amnioscopy

Abstract

One of the most important preventive measures in obstetrics is the termination of pregnancy at the right time. It is difficult to define some important features of fetal maturity in high-risk infants because of the preventive early termination of pregnancy. Laboratory procedufes [3] by which the fetal maturity is evaluated determine the functional maturity of separate organs, or they are able to estimate the completed development of the fetus. By combining several methods [7] one can approach very closely to the real maturity, while any single method shows considerable errors. During routine amnioscopies milky amniotic fluid has frequently been observed immediately before the spontaneous delivery of mature infants. A striking fact was that the delivery began spontaneously with the appearance of milky amniotic fluid although the cervix was not yet ripe. It has been observed further that although the cervix was ripe the delivery did not begin spontaneously if the amniotic fluid was clear. In our hospital, nearly 2500 women have given birth in recent years. Approximately one half of these women have been followed with amnioscopy. Amnioscopy in the non-risk-group is usually started at term, but amnioscopy in the risk group is, of course, started earlier.l Material and methods By amnioscopy [9] the quality of the amniotic fluid proper äs well äs the quantity of vernix Curriculum vitae ]oiE ZABKAR, M. D. y born in 1938 at Krusevac, Yugoslavia. Graduated äs Doctor of Medicine at The School of Medicine, University of Ljubljana, in 1962. From 1966 to 1971 , he speciali^ed in gynecology and obstetrics in Kranj and Ljubljana. Since then, and expecially öfter 1971, he has taken special interest in perinatal medicine. Since 1974, he has been working with Professor SALING in Berlin on a sholarship from the Health Senator of Berlin.caseosa are determined. The amniotic fluid proper is divided into 4 groups: 1. Clear amniotic fluid [9]: Amniotic fluid is water-like clear. No particles of vernix are observed. 2. Clear to milky amniotic fluid: Transparency of amniotic fluid is reduced in its wider layer and one can observe smaller particles of vernix. 3. Milky to clear amniotic fluid: In its wider layer the amniotic fluid is milky, but in its thinner layer it is still clear. Larger flocks of vernix can be observed. 4. Milky amniotic fluid [9]: The amniotic fluid is of pure milky color, consisting of large flocks of vernix. The presenting part of the fetus can be seen only by pressing the amnioscope against it. J. Perinat. Med. 3 (1975) Brought to you by | University of Arizona Authenticated Download Date | 5/27/15 4:35 PM A --n-i were performed in these women. Amniotic fluids 1169 newborns 1960 were collected and they were divided, according to the definition mentionwere then classified, according to duration of ed above, into 4 groups. According to the time J. Pcrinat. Med. 3 (1975) Brought to you by | University of Arizona Authenticated Download Date | 5/27/15 4:35 PM

Lipids in Forehead Vernix from Newborn Infants

“…The similarity in lipid profiles is also good evi dence that the flaking of vernix from fetal skin makes a significant contribution to am niotic fluid sediment in term pregnancies. This is in accord with the amnioscopy studies of Zabkar [ 1 ] who observed the appearance of milkincss in amniotic fluid from term pregnancies and ascribed this change to flecks of vernix.…”

“…This phenome non has been recognised for many years and been attributed to the appearance of flakes of vernix caseosa in the liquor. Zabkar [1] stud ied a large number of near-term pregnancies using amnioscopy and reported a direct rela tionship between the milkiness of amniotic fluid and the flaking of vernix caseosa from the fetal skin. He further demonstrated that most women went into spontaneous labour within 4 days of liquor becoming turbid.…”

Amniotic Fluid Squalene: A Useful Test in Prolonged Pregnancy

“…More recently this phenomenon has been extensively studied using amnioscopy. The milkiness was shown by Zabkar (1975) to be due to the increased presence of specks of vernix caseosa in amniotic fluid at term. Zabkar concluded that the appearance of milky liquor was closely linked with the spontaneous delivery of a mature fetus.…”

Biology of the vernix caseosa: A review

“…The turbidity of amniotic fluid increases with gestational age during the third trimester . Narendran et al .…”