Advertisement
Research Article| Volume 1, ISSUE 2, P199-213, June 1981

Download started.

Ok

Respiratory Distress Syndrome, Fetal Pulmonary Surfactant, and Amniotic Fluid Phospholipid Analysis

  • Robert E. Wenk
    Correspondence
    Division of Clinical Pathology, Sinai Hospital of Baltimore, Baltimore, Maryland 21215
    Affiliations
    Associate Professor of Pathology, Pennsylvania State University, Hershey Medical Center, Hershey, Pennsylvania, Baltimore, Maryland.

    Assistant Professor of Laboratory Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland.

    Head, Division of Clinical Pathology, Department of Pathology, Sinai Hospital of Baltimore, Baltimore, Maryland.
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.
      A simple, inexpensive, and unidimensional thin-layer chromatographic method has been developed for rapidly estimating lecithin, sphingomyelin, and phosphatidyl glycerol extracted from amniotic fluid. Visualization of these three pulmonary surfactant phospholipids permits prediction of respiratory distress of the neonate in normal and complicated gestations.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Clinics in Laboratory Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Alexander J.P.
        The shake test and the respiratory distress syndrome.
        N. Engl. J. Med. 1977; 296: 1236
        • Anaokar S.
        • et al.
        Enzymic assay for lecithin in amniotic fluid.
        Clin. Chem. 1978; 25: 103-107
        • Aubry R.H.
        • et al.
        The lecithin/sphingomyelin ratio in a high risk obstetric population.
        Obstet. Gynecol. 1976; 47: 21-27
        • Badham L.P.
        • Worth H.A.J.
        Critical assessment of phospholipid measurement in amniotic fluid.
        Clin. Chem. 1975; 21: 1441-1447
        • Bichler A.
        • et al.
        Amniotic fluid surface tension measurements versus various phospholipid determinations in the assessment of fetal lung maturity.
        Respiration. 1979; 37: 114-121
        • Blumenfeld T.A.
        • et al.
        Microviscosity of amniotic fluid phospholipids, and its importance in determining fetal lung maturity.
        Clin. Chem. 1979; 25: 64-67
        • Broennle A.M.
        New light on pediatric respiratory problems.
        Crit. Care Med. 1974; 2: 221-224
        • Cheskin H.S.
        • et al.
        Effect of gestational variation of phosphatidylglycerol and phosphatidylglycerol and phosphatidyl inositol on the microviscosity of amniotic fluid phospholipids.
        Clin. Chem. 1980; 26: 301-304
        • Clements J.A.
        • et al.
        Assessment of the risk of the respiratory distress syndrome by a rapid test for surfactant in amniotic fluid.
        N. Engl. J. Med. 1972; 286: 1077-1081
        • Cook C.D.
        Surface tension and the respiratory distress syndrome.
        Proc. Roy. Soc. Med. 1966; 156: 502-503
        • Cowett R.M.
        • et al.
        Foam stability test on gastric aspirate and the diagnosis of respiratory distress syndrome.
        N. Engl. J. Med. 1975; 293: 413-416
        • Cowett R.M.
        • et al.
        Foam stability test on gastric juice in neonates.
        N. Engl. J. Med. 1977; 297: 789
        • Cuestas R.A.
        • et al.
        Low thyroid hormones and respiratory distress syndrome of the newborn.
        N. Engl. J. Med. 1976; 295: 297-302
        • Depp R.
        • et al.
        Antenatal corticosteroids to prevent neonatal respiratory distress syndrome: Risk vs. benefit considerations.
        Am. J. Obstet. Gynecol. 1980; 139: 338-350
        • Duck-Chong C.G.
        • et al.
        Lamellar body phospholipid content of amniotic fluid and L/S ratio compared in assessing fetal lung maturity.
        Clin. Chem. 1980; 26: 766-769
        • Freer D.E.
        • et al.
        Rational basis for foam-stability assays of amniotic fluid surfactant.
        Clin. Chem. 1978; 24: 1980-1984
        • Fujiwara T.
        • Maeta H.
        • Chida S.
        • et al.
        Artificial surfactant therapy in hyaline membrane disease.
        Lancet. 1980; 1: 55-59
        • Gluck L.
        • et al.
        Diagnosis of the respiratory distress syndrome by amniocentesis.
        Am. J. Obstet. Gynecol. 1971; 109: 440-445
        • Gotelli G.
        • et al.
        Simultaneous determination of phosphatidylglycerol and the lecithin/sphingomyelin ratio in amniotic fluid.
        Clin. Chem. 1978; 24: 1144-1146
        • Gross T.L.
        • Cook W.A.
        Tests for maturity of fetal lung.
        N. Engl. J. Med. 1977; 297: 671
        • Hallman M.
        • Teramo K.
        Amniotic fluid phospholipid profile as a predictor of fetal maturity in diabetic pregnancies.
        Obstet. Gynecol. 1979; 54: 703-707
        • Hocking W.G.
        • Golde D.W.
        The pulmonary-alveolar macrophage.
        N. Engl. J. Med. 1979; 301: 641-642
        • King R.J.
        The surfactant system of the lung.
        Fed. Proc. 1974; 33: 2238-2247
        • Knox E.
        • et al.
        The effect of amniography on amniotic fluid L/S ratio.
        Obstet. Gynecol. 1977; 49: 154-155
        • Kolins M.D.
        • et al.
        Amniotic fluid phospholipids measured by continuous development thin-layer chromatography.
        Clin. Chem. 1980; 26: 403-405
        • Kulovich M.
        • et al.
        The lung profile. I. Normal pregnancy.
        Am. J. Obstet. Gynecol. 1979; 135: 57-63
        • Kulovich M.
        • Gluck L.
        The lung profile. II. Complicated pregnancy.
        Am. J. Obstet. Gynecol. 1979; 135: 64-70
        • Massod S.
        Amniotic fluid analysis in assessment of fetal maturity.
        Am. J. Clin. Pathol. 1977; 68: 235-237
        • Mitnick M.A.
        • et al.
        Amniotic fluid phosphatidylglycerol and phosphatidylinositol separated by stepwise-development thin-layer chromatography.
        Clin. Chem. 1980; 26: 277-281
        • Morley C.J.
        • Miller N.
        • Bangham A.D.
        • et al.
        Dry artificial surfactant and its effect on very premature babies.
        Lancet. 1981; i: 64-68
        • Morrison J.C.
        • et al.
        The lecithin/sphingomyelin ratio in cases associated with fetomaternal disease.
        Am. J. Obstet. Gynecol. 1977; 127: 363-368
        • Mueller-Henback E.
        • et al.
        Lecithin/sphingomyelin ratio in amniotic fluid and its value for the prediction of neonatal respiratory distress syndrome in pregnant diabetic women.
        Am. J. Obstet. Gynecol. 1978; 130: 28-34
        • Olson E.B.
        • et al.
        Amniotic fluid lecithin to sphingomyelin ratio of 3.5 and fetal pulmonary maturity.
        Pediatr. Res. 1975; 9: 65-69
        • Painter P.C.
        Simultaneous measurement of lecithin, sphingomyelin, phosphatidylglycerol, phosphatidyl inositol, phosphatidyl ethanolamine and phosphatidyl serine in amniotic fluid.
        Clin. Chem. 1980; 26: 1147-1151
        • Pattle R.E.
        Surface lining of lung alveoli.
        Physiol. Rev. 1965; 45: 48-79
        • Pattle R.E.
        • et al.
        Maturity of fetal lungs tested by production of stable microbubbles in amniotic fluid.
        Br. J. Obstet. Gynaecol. 1979; 86: 615-622
        • Pearson R.
        Lecithin/sphingomyelin ratios and sex incidence of respiratory destress syndrome.
        Lancet. 1976; i: 960
        • Railsback K.P.
        • Haller W.S.
        Lecithin/sphingomyelin ratios in centrifuged and uncentrifuged amniotic fluid.
        Am. J. Med. Technol. 1978; 44: 852-854
        • Robert M.G.
        • et al.
        Association between maternal diabetes and the respiratory-distress syndrome in the newborn.
        N. Engl. J. Med. 1976; 294: 357-360
        • Shelley S.A.
        • et al.
        Sequential changes of surfactant phosphatidylcholine in hyalinemembrane disease of the newborn.
        N. Engl. J. Med. 1979; 300: 112-116
        • Smith B.T.
        Long maturation in the fetal rat: Acceleration by injection of flbroblast-pneumonocyte factor.
        Science. 1979; 204: 1094-1095
        • Statland B.E.
        • Freer D.E.
        Evaluation of two assays of functional surfactant in amniotic fluid; surface tension lowering ability and the foam stability index test.
        Clin. Chem. 1979; 25: 177-183
        • Tchobrioutsky C.
        • et al.
        The lecithin/sphingomyelin ratio in 132 insulin-dependent diabetic pregnancies.
        Am. J. Obstet. Gynecol. 1978; 130: 754-759
        • Teramo K.
        • Hallman M.
        Phospholipid studies of the amniotic fluid in diabetic pregnancy.
        Acta Endocrinol. 1980; 238: 21-23
        • Tsai M.Y.
        • Marshall J.G.
        Phosphatidyl glycerol in 261 samples of amniotic fluid from normal and diabetic pregnancies, as measured by one-dimensional thin layer chromatography.
        Clin. Chem. 1979; 25: 682-685
        • van Voorsttof Voorst E.J.G.M.
        Effects of centrifugation, storage, and contamination of amniotic fluid on its total phospholipid content.
        Clin. Chem. 1980; 26: 232-234
        • Weller P.H.
        • et al.
        Pharyngeal lecithin/sphingomyelin ratios in newborn infants.
        Lancet. 1976; 1: 12-14
        • Worth H. G.J.
        • Wright D.J.
        Colorimetric determination of phospholipids by use of molybdophosphate, and its application to amniotic fluid.
        Clin. Chem. 1977; 23: 1995-2000

      Analysis of Lecithin, Sphingomyelin, and Phosphatidyl Glycerol in Amniotic Fluid

        • Kolins M.D.
        • et al.
        Amniotic fluid phospholipids measured by continuous-development thin-layer chromatography.
        Clin. Chem. 1980; 26: 403-405
        • Kulovich M.V.
        • et al.
        The lung profile. I. Normal pregnancy.
        Am. J. Obstet. Gynecol. 1979; 135: 57-63
        • Kulovich M.N.
        • Gluck L.
        The lung profile. II. complicated pregnancy.
        Am. J. Obstet. Gynecol. 1979; 135: 64-70
        • Painter P.C.
        Simultaneous measurement of lecithin, sphingomyelin, phosphatidyl glycerol, phosphatidyl inositol, phosphatidyl ethanolamine and phosphatidyl serine in amniotic fluid.
        Clin. Chem. 1980; 26: 1147-1151
      1. Regis Chemical Company, Operation Manual, SB/CD — Short bed continuous development, Morton Grove, Illinois, 1979, pp. 9-10

        • Teramo K.
        • Hallman M.
        Phospholipid studies of the amniotic fluid in diabetic pregnancy.
        Acta Endocrinol. 1980; 238: 21-23
        • Torday J.
        • et al.
        Saturated phosphatidyl choline in amniotic fluid and prediction of the respiratory distress syndrome.
        N. Engl. J. Med. 1979; 301: 1013-1018
        • Wenk R.E.
        • et al.
        Amniotic fluid and antenatal diagnosis.
        in: Henry J.B. Clinical Diagnosis and Management by Laboratory Methods. Edition 16. W. B. Saunders Co, Philadelphia1979: 693-711
      2. Wenk, R. E.: Amniotic fluid phospholipids. Check Sample, Special Topics — Advances in Clinical Chemistry No. ACC-80-4 (ACC-36), Chicago, American Society of Clinical Pathologists, Feb. 1981