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Three methods compared for determining phosphatidylglycerol in amniotic fluid.

R A Coapman-Hankin, F L Kiechle, E Epstein

Clinical Chemistry

|August 1, 1985

Summary

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The Amniostat-FLM test for phosphatidylglycerol in amniotic fluid is rapid but insensitive, missing many positive results detected by thin-layer chromatography.

Area of Science:

Obstetrics and Gynecology
Clinical Chemistry
Biochemistry

Background:

Phosphatidylglycerol (PG) is a key phospholipid in amniotic fluid.
Conventional thin-layer chromatography (TLC) for phospholipid measurement faces interferences.
PG measurement is crucial for assessing fetal lung maturity.

Purpose of the Study:

To compare the diagnostic performance of a rapid immunological agglutination test (Amniostat-FLM) against two-dimensional thin-layer chromatography (2D-TLC) for phosphatidylglycerol detection.
To evaluate the sensitivity and specificity of the Amniostat-FLM test in amniotic fluid samples.

Main Methods:

Analysis of 41 amniotic fluid specimens (31-40 weeks gestation) for phosphatidylglycerol using Amniostat-FLM and 2D-TLC.
Assay of 14 specimens using an enzymic, colorimetric procedure for confirmation.

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Main Results:

The Amniostat-FLM test showed limited sensitivity, detecting PG in only 7 of 23 specimens positive by 2D-TLC.
The test yielded false-negative results in 8 specimens where PG was present (detected by enzymic assay).
Amniostat-FLM appears to detect PG only at concentrations >25 mumol/L or >15% of total phospholipids.

Conclusions:

The rapid immunological agglutination test (Amniostat-FLM) is not sufficiently sensitive for reliable detection of phosphatidylglycerol in amniotic fluid.
Thin-layer chromatography remains a more reliable method for assessing fetal lung maturity via phosphatidylglycerol levels.
Clinical use of Amniostat-FLM for fetal lung maturity assessment requires caution due to its low sensitivity.