Amniotic fluid phosphatidylglycerol: a predictor of fetal lung maturity using conventional one-dimensional thin-layer chromatography.

We present a retrospective comparative analysis of 209 amniotic fluid samples and the neonatal outcome. The presence of phosphatidylglycerol in 159 transabdominal amniotic fluid samples and the associated lung status indicated a 98% prediction rate for absence of respiratory distress syndrome with 1.8% false-positive results corrected to 0%. Twenty-nine vaginal pool samples were 72% predictive of outcome with false-positive results corrected to 14%. These cases were mild, and if a phosphatidylglycerol level of greater than 3% is used to indicate lung maturity, the corrected false-positive rate is 0%. False-negative results are also corrected and discussed. We believe that predicting neonatal respiratory distress syndrome by phosphatidylglycerol determination, using readily available conventional one-dimensional thin-layer chromatography, is clinically reliable and can aid in determining the maturity of the lung regardless of site of fluid collection.

Breech delivery: impact of increasing cesarean section delivery.

We present a retrospective analysis of neonatal outcome and maternal morbidity in the delivery of 192 infants presenting by the breech position, weighing more than 1,000 gm, and exhibiting fetal heart tones upon admission. All of the deliveries occurred between Jan 1, 1975 and Dec 31, 1978. Over the study period the cesarean section rate increased from 35.9% to 73.3%, and maternal morbidity increased from 17.9% to 35.0%. Maternal morbidity in the cesarean section group in 1978 was 41%. Three of the four neonatal deaths were attributed to anomalies group in 1978 was 41%. Three of the four neonatal deaths were attributed to anomalies incompatible with life, and the fourth was due to severe respiratory distress syndrome in a markedly premature infant. Traumatic neonatal morbidity occurred almost exclusively in the vaginally delivered group with only one case of traumatic morbidity in the cesarean section group. Apgar scores of the infants weighing less than 2,500 gm were significantly improved in the cesarean section group (P less than .01), but no significant difference was seen in the five-minute Apgar score in the infants weighing more than 2,500 gm.