ABSTRACT
Grade III placentas were found in 133 (12 per cent) of 1,082 pregnant women evaluated ultrasonographically after 20 weeks of gestation. Associated biparietal diameter measurements ranged from 7.2 to 10 cm. In 11 women with no complications known to accelerate fetal lung maturity or to induce premature placental maturation, grade III placentas were observed between 30 and 33 weeks of gestation. Gestational ages determined according to the growth adjusted sonographic age method of Sabbagha were accurate within one to three days. Considering the risk of hyaline membrane disease at those gestational ages, a grade III placenta cannot be equated with fetal lung maturity. Criteria other than placental grading should be used to assess the pulmonary status of the fetus.
Subject(s)
Placenta/anatomy & histology , Ultrasonography , Female , Fetal Organ Maturity , Gestational Age , Humans , Hyaline Membrane Disease/diagnosis , Infant, Newborn , Lung/embryology , Phosphatidylcholines/analysis , Placenta/analysis , Pregnancy , Sphingomyelins/analysisABSTRACT
We measured the microviscosity of amniotic fluid between 28 and 40 weeks of gestation in 252 normal pregnancies and in 172 pregnancies complicated by factors known to influence fetal lung maturation, including chronic high blood pressure, pregnancy-induced hypertension, diabetes mellitus, and therapy with betamethasone. Comparison of the microviscosity value distributions and regression analysis indicated significantly lower microviscosity values in hypertensive disorders, in Class D and Classes F or R diabetes, and after 48 h of treatment with betamethasone. Few changes were observed in Classes A, B, or C diabetes. These observations are consistent with the accelerated maturation of surfactant observed in chronic intrauterine stress and the lower incidence of hyaline membrane disease reported after glucocorticoids.
