الفهرس 
Subject and methodsOnly 14 pages are availabe for public view
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Abstract
Amniocentesis with determination of the phospholipid profile (LIS
ratio and PG levels) remains the most useful and universally acceptable
estimate of fetal pulmonary maturity.
Amniocentesis, however, is an invasive procedure with a small but
significant fetal and maternal morbidity rate up to 15% in third trimester of
pregnancy.
Ultrasonic evluation of fetal lung maturity was done on 90 patients
whose gestational ages ranged from 28 to 42 weeks. Seven parameters
were studied, namely : BPD, distal femoral and proximal humoral
epiphysis, lunglliver ratio, fetal bowel pattern, placental maturity and
amniotic fluid fleckers. A scoring system (13 Points) was designed to
include the 7 parameters. All the cases were delivered within 24 hours of
DiS examination.78 cases had no RDS (G1) while 12 cases had RDS (G2).
The mean gestational age and BPD were significantly lower in G2
than G1 (P<0.001) . Distal femoral epiphysis was significantly larger in G1
than G2 (P<O.OOI). Lung/liver ratio showed a significantly higher
incidence of hyperdense lung in G1 than G2 (P<O.OOI).The incidence of
mature fetal bowel was significantly higher in G1 than G2 (97% Vs 66%,
P<O.OOI).
Grade III placentae showed no RDS. Amniotic fluid was turbid in
81% in G•• compared to 58% in G2 (P < 0.05).
The mean fetal lung maturity score was significantly higher in G1
than G2 (9.7±2.3 Vs 3.7±2.2, P<O.OOI). Ultrasonic fetal lung maturity
score (z 7) showed : 88.5% sensitivity, 91.7% specificity, 55% positive
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predictive value, 98% negative predictive value and 88.9% total accuracy
in predicting fetal lung maturity. A score of 8 or more is almost conclusive
of mature lungs.
Conclusion:
Sonographic evaluation of fetal lung maturity can provide valuable
information and act as a rapid, easy, non invasive and accurate test for
detection of fetal lung maturity. A score of eight or more is conclusive of
lung maturity while a score of seven or more carries only 2% risk of RDS
which is acceptable even if compared to results of standard lung maturity
tests.
But due to the limited number of cases this score needs further
evaluation on a large scale of cases specially abnormal pregnancy.