Modified Scoring System for Fetal Lung Maturity

Description

The degree of fetal maturity is important in obstetrical decision making for high risk pregnancies. An immature fetus is an high risk for respiratory problems and for death. In many situations there is difficulty deciding between the risk to the fetus from continued intrauterine gestation and the risk from early delivery. Analysis of amniotic fluid can help determine if the fetus is sufficiently mature to be delivered safely. This scoring system antedates several newer tests for fetal lung maturity.

Testing -Analyze amniotic fluid for :

(1) creatinine

(2) ?OD450 (height of spectrophotometric peak at 450 nm above baseline, associated with bilirubin)

(3) percent fat cells

(4) lecithin, sphingomyelin, and the lecithin-to-sphinogomyeline (L/S) ratio

(5) The presence or absence of the distal femoral epiphysis on ultrasound.

Amniotic Fluid Parameter	Finding	Points
creatinine in mg/dL	< 1.5	0
	1.5 - 1.9	1
	> 1.9	2
?OD450	> 0.04	0
	0.02 - 0.04	1
	< 0.02	2
fat cells in percent	< 10	0
	10 – 19	1
	> 19	2
L/S ratio	< 1.6	0
	1.6 – 1.9	1
	> 1.9	2
distal femoral epiphysis	absent	0
	equivocal	1
	present	2

score for fetal maturity == (creatinine points) + (?OD450 points) + (fat cell points) + (L/S ratio points) + (distal femoral epiphysis points)

Interpretation:

• score >= 6: mature

• score < 6: immature

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Modified Scoring System for Fetal Lung Maturity

Description

Specialty