Amniotic fluid indices of fetal pulmonary maturity with preterm premature rupture of membranes

Objective: To evaluate the performance of the TDx/TDxFLx fetal lung maturit y II assay (Abbott Laboratories; Abbott Park, IL) on amniotic fluid (AF) sp ecimens collected vaginally from women with preterm premature rupture of me mbranes (PROM). Methods: We reviewed charts of patients with preterm FROM treated at Shands Hospital at the University of Florida from January 1, 1995, to June 30, 19 99. Negative predictive values (prediction of the absence of neonatal respi ratory distress) of mature (at or above 55 mg/g) and borderline (40-54 mg/g ) test results were calculated for 153 women. Results: Respiratory distress syndrome (RDS) occurred with frequencies of o ne in 42 and three in 29 cases with mature and borderline test results, res pectively. All cases of RDS were mild, defined as sustained tachypnea with or without need for supplemental oxygen. With an immature (less than 40 mg/ g) test result, 20 of 82 infants developed RDS, and half of those cases wer e severe, defined as needing mechanical ventilation. Negative predictive va lues of mature and borderline tests were 97.6% (95% confidence interval [CI ] 92.9, 100) and 89.7% (95% CI, 78.3, 100), respectively. Conclusion: Mature results from fetal lung maturity tests of vaginally coll ected AF predict the absence of RDS with a high degree of accuracy. (Obstet Gynecol 2000;96:102-5. (C) 2000 by The American College of Obstetricians a nd Gynecologists.).