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AMNIOTIC FLUID LECITHIN AND ITS FATTY ACID COMPOSITION IN RESPIRATORY DISTRESS SYNDROME

In a prospective study, specimens of amniotic fluid were obtained at parturition from 853 consecutive patients. Nine of the infants, with a gestational age of 25 to 37 weeks, developed respiratory distress syndrome (RDS). The amniotic fluid phospholipids were analyzed in these nine patients and in two other groups: one consisted of 15 patients with a gestational age of 35 weeks and the other of 80 randomly selected full‐term pregnancies. None of the infants in these two groups developed RDS. The total amniotic fluid phospholipids were analyzed by thinlayer chromatography without preceding precipitation in acetone, and the fractions were isolated and quantitated by phosphorus determination. In addition, the fatty acid composition of the lecithins was determined. The mean concentration of the total phospholipids and the lecithin/sphingomyelin ratio were significantly lower in the RDS group than in the other two groups with healthy infants. In the RDS group there was also a significantly lower proportion of palmitic acid in the amniotic fluid lecithins. The present investigation clearly demonstrates that analysis of total amniotic fluid phospholipids should be of great value in estimating the pulmonary maturity of the fetus.