Coulld it be something like PI DSL? sm
Posted By: wild guess on 2006-02-03
In Reply to: Positive fetal lung maturity as per s/l - puh tel
Subject: Coulld it be something like PI DSL? sm
- Indications: Assessment of fetal lung maturity
- Gestational age of 34 weeks or more
- Assess risk of Hyaline Membrane Disease
- Signs of adequate surfactant (requires amniocentesis)
- Lecithin to Sphingomyelin ratio (L/S ratio) > 2:1
- Positive Predictive Value: 98% (if no comorbidity)
- Not accurate in Diabetes, fetal asphyxia, Rh Disease
- Phosphatidylglycerol (PG) present >3%
- More reliable than L:S ratio if maternal comorbidity
- Phosphatidylinositol (PI) present
- Desaturated Lecithin (DSL)
- Non-Diabetic Patient >1500
- Gestational Diabetes Mellitus >2000
- Most sensitive of all lung maturity tests
- Total surfactant activity tests
- Fetal Lung Maturity Test (TDX-FLM, Abbott Labs) >70%
- Foam Stability Index (Beckman Inst.) >47
- Bedside Tests
- Tap Test
- Mix amniotic fluid with indicators
- Start with 1 ml amniotic fluid
- Add one drop of 6N Hydrochloric acid
- Add 1.5 ml Diethyl ether
- Tap tube several times
- Forms several hundred bubbles in ether layer
- Interpretation
- Mature if <6 bubbles in ether layer at 10 minutes
- Surfactant expedites bubbles breaking down
- Turbidity Test
- Hold amniotic fluid tube over newsprint
- Mature if fluid prevents reading newsprint
- Amniotic fluid turbidity increases with surfactant
- Positive Predictive Value: 97%
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