태아폐숙성도 측정을 위한 선별검사의 효용성

Abstract

To assess the fetal lung maturity for determining the time of delivery in high risk pregnancy, we obtained 113 samples of amniotic fluid from 105 high risk pregnancy women, and shake test, amniotic fluid absorbance at 650 nm, 400 run, and Amniostat-FLM(AFLM) were performed for the screening test of the fetal lung maturity. We investigated the diagnostic reliability of the fetal lung maturity test in 54 cases of good fetal lung maturity at birth, delivered within 72 hours after last amniocentesis and 4 cases of respiratory distress syndrome (RDS) at birth. The sensitivity and predictive value of mature test were 100 % in all screening test. The specificity and efficiency were 83.3 %, 84.5 % in shake test, 70.4 %, 72.4 %, in OD 400 nm, 61.1 %, 63.8 % in OD 650 nm, 70.4 % in AFLM. The predictive value of RDS was 30.5 % in shake test, 20.0 % in OD 40 nm, 16.0 % in OD 650 nm, 20.0 % in AFLM. If a good fetal lung maturity is assigned as any one of two was positive in all screening test, AFLM and shake test showed 89.7 % efficiency. If a good fetal lung maturity is assigned as any one of three was positive in all screening tests, and OD 400 nm or AFLM, shake test, and OD 650 nm. Conclusively, the screening test of fetal lung maturity for determining the time of delivery in high risk pregnancy is more effective with multiple screening tests than single test. Further studies will be needed in the efficiency of other screening tests, comparison studies with lung profile and vaginal samples.