1023 PREDICTIVE VALUE OF VAGINAL AMNIOTIC FLUID L/S RATIO IN PREMATURE RUPTURE OF MEMBRANES

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    • Abstract:
      Use of the L/S ratio in management of pregnancy complicated by premature rupture of membranes (PROM) is well documented. Samples are usually obtained by amniocentesis, but there are complications and limitations to that approach. The availability of amniotic fluid per vaginum with PROM suggests attention be given to vaginal fluid determinations. Specimens collected by protocol were obtained from 25 women with pregnancies ranging from 29 to 36 weeks, PROM, and no other complications.All infants were managed in our ICN and pulmonary diagnosis was rigidly defined. Twenty-three infants with L/S ratios from 1.3 to 5.8 had no respiratory problems. Two infants, both of 32 weeks gestational age, developed respiratory difficulties: 1 with L/S ratio of 1.1 had RDS, and 1 with L/S ratio of 2.4 had aspiration pneumonitis. Of 23 cases with no respiratory problems, 2 L/S ratios were immature (1.3 and 1.4) and 5 were transitional (1.6 to 1.9). No infants had signs of sepsis. This range of results is comparable to studies reporting samples obtained by amniocentesis. Our study to date suggests that vaginally obtained amniotic fluid for L/S determination has predictive value for neonatal pulmonary maturity and is useful in the management of PROM.