Lung profiles in the isoimmunized pregnancy

The management of an isoimmunized pregnancy, although not commonly seen today, represents a challenging obstetric problem. The knowledge of fetal lung maturity status is essential in deciding when to perform an intrauterine transfusion, give steroids, or deliver an infant. The interpretation of the fetal lung profile in these patients has been questioned. Charts were reviewed from 99 isoimmunized patients cared for at Los Angeles County/University of Southern California Medical Center, Women's Hospital, from March, 1981, through December, 1983. There were 77 patients who underwent 260 amniocenteses. The lecithin-sphingomyelin ratio, dipalmitoyl phosphatidylcholine, phosphatidylinositol, and phosphatidylglycerol from the amniotic fluid did not differ from the values expected in normal gestations. There were a total of six patients who underwent intrauterine transfusions and the lung profile data were consistent with anticipated values. We conclude that lung maturation is neither delayed nor accelerated in the isoimmunized pregnancy.