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Determination of Lecithin–Sphingomyelin Ratio in Amniotic Fluid

From the Department of Obstetrics and Gynecology, Michael Reese Hospital and Medical Center and the Pritzker School of Medicine of the University of Chicago.

Abstract

Modifications have been incorporated in the method of Gluck and others for determining the lecithin–sphingomyelin ratio (L/S) in amniotic fluid. After thin-layer chromatography in chloroform:methanol:water, 12:5:1, the phospholipids are visualized by phosphomolybdic acid reagent. The untoward effects of storage, at room temperature, on the stability of L/S and the effects of amniotic fluid contamination with meconium or plasma on the L/S ratio have been investigated. In the followup of 41 pregnancies, low lecithin–sphingomyelin ratios, < 1.0, were confirmed before week 29, correctly predicting the development of respiratory distress syndrome in the premature newborn. In pregnancy of unknown duration or near term, low L/S values oblige one to maintain pregnancy until repeated sampling confirms fetal lung maturity.