Assessing Fetal Lung Maturity
The status of fetal lung maturity must be known prior to elective repeat cesarean section. Relying on calculated dates is subject to various possibilities for error. Maternal estradiol and use of ultrasound to determine fetal size are helpful but do not correlate precisely with fetal lung maturity. Use of amniocentesis and measurement of either lecithin-sphingomyelin ratio (Gluck L: Am J Obstet Gynecol 109:446, 1971) or foam stability (Clements JA: N Engl J Med 286:1077, 1972) tests should be done to assess lung maturity. If the test result gives evidence of an immature fetal lung, the delivery of the fetus should be postponed.
