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Correlation of Ultrasonic Epiphyseal Centers and the Lecithin

Sphingomyelin Ratio

From the UCLA School of Medicine, Department Obstetrics and Gynecology, Los Angeles, California.

Ossification centers about the fetal knee were identified and measured by ultrasound in 133 nondiabetic patients who underwent amniocentesis for determination of the amniotic fluid lecithin:sphingomyelin ratio (L:S ratio) between 28 and 42 weeks' gestation. A distal femoral epiphysis measuring greater than or equal to 5 mm and a proximal tibial epiphysis measuring 3 mm or greater was seen at 34 to 35 weeks' gestation. A mature lecithin:sphingomyelin ratio (lecithin:sphingomyelin greater than or equal to 2.0) was present with 66, 94, and 100% of proximal tibial epiphysis measuring 0 to 2, 3 to 4, and 5 to 7 mm, respectively. A mature lecithin: sphingomyelin ratio was present with 39, 76, and 95% of distal femoral epiphysis measuring 0 to 2, 3 to 4, and 5 to 7 mm, respectively. These results suggest that in nondiabetic patients, the ossification centers about the fetal knee as measured by ultrasound correlate well with amniotic fluid lecithin: sphingomyelin ratio.