Amniotic Fluid Correlates of Fetal Maturity and Perinatal Outcome

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Abstract
The determination of amniotic fluid total lecithin/sphingomyelin ratio, creatinine concentration, fetal fat cells and presence of bilirubin (Δ OD450) was used to study 201 amniotic fluids from 144 pregnancies. The total L/S ratio and creatinine concentration correlated significantly with gestational age and fetal size in normal gestations as well as those complicated by diabetes, toxemia and Rh-isoimmunization. The presence of fetal fat cells and the optical density at 450 nm were found to be less accurate parameters for dating gestation and fetal maturity. In 6 infants delivered with a total L/S ratio < 2.0 and creatinine concentration < 1.75 mg%, 3 (50%) died from severe RDS and hyaline membrane formation, 1 developed mild RDS and recovered, and 2 showed no symptoms of respiratory distress. The utilization of the total L/S ratio in combination with the creatinine content is the most accurate method for in utero assessment of fetal maturity and perinatal survival.

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