Question

•Bonnie is 36 weeks and her physician is concerned that the fetus is showing signs of distress.  She orders a “lung profile” which consists of determining the L/S ratio and measuring the percent phosphatidylglycerol (PG) on amniotic fluid.  The results are:

•L/S ratio = 1.0

•PG ratio = 0.3%

1.What is the interpretation of these test results?

Answer 1

Amniotic fluid specimen taken to assess the fetal lung maturity in complicated pregnancy to avoid respiratory distress, or to assess respiratory distress.

Lecithin/ sphingomyelin ratio is test to help in the assessment of respiratory distress, to prevent the collapse of lungs in the newborn, it is necessary to have a surfactant in the lungs. Surfactant is a mixture of lecithin, sphingomyelin, glycoprotein, lipids and protein.

L/S ratio is a marker of fetal lungs maturity, if L/S ratio is high (2 or more) means high level of surfactant and low risk of respiratory distress at the time of birth, level is 1.5 or less means low amount of surfactant and high risk of respiratory distress.

If level is low, mother received steroid to help in support for the formation of surfactant.

Another marker of fetal lungs maturity is phosphatidylglycerol (PG) is phospholipid surfactant present in the lungs. It helps in the spread of phospholipid and its presence indicate the advanced level of fetal lung maturity. It use to be assess late in pregnancy.

If level is less than 0.3% the fetal lung maturity is compromised and lungs is not mature enough and risk of respiratory distress is high.

L/S ratio is more indicative marker for distress and PG assess late in the pregnancy.

In given case client vale is low than the normal and high risk of respiratory distress can be occur. In this case physician administered dexamethasone a steroid which help in the lung maturity.

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