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Amniocentesis
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Aris Antsaklis, Marianna Theodora
Fetal lung maturity can be assessed indirectly using both qualitative and quantitative characteristics of amniotic fluid. Pulmonary maturity can be assessed by the measurement of lecithin/sphingomyelin ratio or the concentration of phosphatidylglycerol in amniotic fluid. Similarly, the detection of lamellar bodies and the study of other characteristics of the amniotic fluid may give information about lung maturity. However, the improvement in neonatal care and the accurate confirmation of gestational age with ultrasound early in pregnancy have diminished the need for examination of amniotic fluid and thus amniocentesis in order to confirm lung maturity.
DRCOG MCQs for Circuit B Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Risk factors for respiratory distress syndrome (RDS) include:Diabetic mother.Birth weight at term < 10th centile.Born before 32 weeks' gestation.Steroid administration between 28 and 32 weeks' gestation.Lecithin/sphingomyelin ratio of <2 and no phosphatidylglycerol.
Physiology of the Neonate
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
The bronchial tree of the fetal lungs is fully developed by 16 weeks of gestation. By 28 weeks, the pre-acinar pattern of airways, arteries and veins is formed with capillaries in the alveolar walls. Type II pneumocytes of the alveolar epithelium are seen by 24 weeks of gestation, and surfactant can be detected in lung extracts from 23 weeks onwards and in fetal tracheal fluid by 28 weeks. Surfactant production in the fetal lung is increased by the administration of cortisol and thyroxine to the mother. Surfactant production is associated with an increase in lecithin in the amniotic fluid. The concentration of sphingomyelin is constant throughout pregnancy, and a lecithin/sphingomyelin ratio greater than 2 is normally present by 36 weeks of gestation.
Echogenic particles in the amniotic fluid of term low-risk pregnant women: does it have a clinical significance?
Published in Journal of Obstetrics and Gynaecology, 2021
Gul Nihal Buyuk, Z. Asli Oskovi-Kaplan, Serkan Kahyaoglu, Yaprak Engin-Ustun
Older studies on free-floating particles in amniotic fluid proposed that these images would represent foetal lung maturity in the last trimester and was associated with vernix and lecithin/sphingomyelin ratio (Gross et al. 1985). Higher maternal serum alpha-fetoprotein levels were also reported in early second trimester pregnant women (Hallak et al. 1993). Several hypotheses on the cause of these particles have been proposed including foetal skin fragments, blood, vernix caseosa, and meconium (Hallak et al. 1993). The acrania-anencephaly sequence in the first trimester, harlequin ichthyosis, and epidermolysis bullosa are other rare causes of echogenic amniotic fluid appearance (Cafici and Sepulveda 2003; Dural et al. 2014).