270 SPO Abstracts

77 FETAL LUNG MATURITY TESTS AND DIABETES MELLITUS. J A Spinnato. MD, C Marcell, RN, S Buck, MD', J A Spin nato, lIP. University of Louisville, Louisville, KY

Three hundred fifteen patients whose gestations were well dated by clinical (lst trimester examination) or ultrasound (before 24 weeks) criteria were assessed for fetal pulmonary maturity by transabdominal amniocentesis. Sixty-eight patients with diabetes mellitus (OM) were compared to 262 non-diabetic (NOM) patients whose gestational ages were between 33 and 40 weeks' gestation to test the hypothesis that tests of fetal maturity were less likely to be mature among DM patients at any gestational age. Among the NDM patients (mean gestational age (MGA) = 35.9 ± 1.9 weeks), the mean LS ratio was 2.7 ± 1.6 and the percent positive for phosphatidylglycerol (PG) was 26%. Among DM patients (MGA = 36.8 ± 1.8 weeks) the mean LS ratio was 3.5 :t 2 and PG was positive in 50%. At each gestational age the mean LS ratio and percent positive for PG among DM patients equaled or exceeded that of NDM patients. Sixty-five percent (n = 127) of NDM patients and 85% (n = 58) of DM patients were noted to have an LS ratio equal to or greater than 2.0. Among these cases, the NDM patients (MGA = 36.5 :t 1.9) were positive for PG In 39% (20/127) and the DM patients were positive for PG in 59%. The percent positive for PG among DM patients equaled or exceeded that of NDM patients at each gestational age. The hypothesis that delayed evidence of fetal pulmonary maturity occurs among diabetic patients is rejected.

78 THE EFFECT OF MAGNESIUM SULFATE INFUSION ON HOURLY FETAL URINE PRODUCTION (HFUP) SJ Carlan MD,' WF O·Br.en MD, C Kalter MD, A Shattey MS University of South Florlda Medical School, Tampa, Florlda.

F. fteen non-l abori ng term pregnant women schedul ed for externa 1 cephal i c verSl0n underwent u1 trasound est lmat 1 on of HFUP before and after MgSO.. Other than breech presentatlOn. the pregnanci es were uncomp I. cated. The pat. ents were NPO for 4 hrs pr.or to and during the study. An IV of R.ngers Lactate was begun and a MgSO. solut.on was prepared by add.ng 25 gr of MgSO.*7H,0 to 250 cc' s of D5W. Keep. ng the total rate at :: 125 cc/hr., a 6 gr MgSO. bolus wa s g. ven over 30 m. n . A 4 g / hr rna Intenance dose was • nfused for 1 hr, at wh. ch t .me serum magnesi urn concentrat. on was determ. ned and the second HFUP was performed. (T.me between measurements 90-120 m.n. t ota l flu.d < 250 cc·s). The method of calculat.ng the HFUP by serlal u 1t rasound bladder measurements was 1 dent 1 ca 1 to prevl DUS

reports w.th the except.on of mak.ng bladder observat.ons q 3-7 m.n, rather than q 15-30 m.n

Mat age (yrs) Mat wt (lbs) EGA (wks) EFW FL/AC (G) Mag level (mg%)

RESUL TS Mean .E 26.5 Pre mag HFUP 43 cc/hr 160 Post mag HFUP 52 cc/hr 38.3 Change. n HFUP 8.9 cc/hr <.05 3433 Pre mag HFUP/kg 11 6 cc/kg/hr 5.7 Post mag HFUP/kg 14.1 cc/kg/hr

Change HFUP/hr 2.5 cc/kg/hr < 05

CONCLUS IONS : 1) HFUP was h. gher than prevlOUS 1 y repor ted . probab 1 y refl ect. ng the more frequent ultrasound observat IOns 2) Magnes.um sulfate .nfus .on .ncreases the HFUP.

J.lnU.ln IY! H Am J Ohslet G~ n<,<ol

79 RELATIONSHIP BETWEEN MATERNAL SERUM AND AMNIOTIC FLUID GLUCOSE LEVELS. Yitzhak Romem, M.D.,Alva Loven, B.Sc.,x Galila Agam, Ph.D.,x Joseph R. Lieber­man M.D., Department of Obstetrics and Gynecology, "Soroka" Medical Center, Ben-Gurion Univ., Beer-Sheva, Israel.

The amniotic fluid (AF) glucose originates from maternal serum (MS). A significant statistical relationship between MS and AF glucose levels was implied in spite of a low coefficient of correlation (r) cited in some papers. The objective of the study was to examine the influence of the time interval between blood drawing and amniocentesis on r. MATERIALS AND METHODS: Glucose levels were determined in 73 paired samples of MS and AF from normal patients undergoing genetic amniocentesis at 16-17 weeks of preg­nancy. The MS and AF samples were obtained at different time intervals from O'to over 140'. RESULTS: The best positive coefficient of correlation was found at 121'-140', r = 0.96, p<O.Ol. CONCLUSION: The AF glucose levels reflect the MS glucose levels after period of 120'-140'.

80 Obstetric Correlates of Neonatal Retinal Hemorrhage; Mark C. Williams, M.D., William F. O'Brien, M.D., Avery WeiSS, M.D., Robert A. Knuppel, M.D., and William N. Spellacy, M.D., University of South Florida, Tampa, Florida

The exact etiology of neonatal retinal hemorrhage (NRH) remains unclear. NRH is more often seen in term infants, occurs to some degree in up to 50",(, of births, and is rarely seen in infants born to mothers of advanced parity. Similarly, the clinical significance of NRH is debated. Early reports found little clinical utility, while more recently it has been found to be possibly associated with delayed psychological and behavioral abnormalities (Gillebo, 1987). Methods: 244 term neonates were screened for NRH (102 wrth operative and 142 With spontaneous vaginal delivery). Delivering physicians recorded labor and delivery course data at delivery. All infants had umbilical artery blood gas determination at delivery, and an ophthalmologic exam within 48 hours of life. Data was analyzed with PC-SAS and t-tests and Chi-square analysis performed where appropriate. Results: Umbilical cord pH was found to correlated with both the presence or absence of NRH (p<O 10) and degree of NRH (p<0.014). The mode of delivery did not appear significantly related to NRH. Finally, infants found to have moderate or severe NRH differed from the unaffected infants in birthweight (3135 vs 3349 gm, p<0.OI0), length (48.7 vs 49.1 cm, p<0.05), and ponderal index (2.71 vs 2.79, p<O.OI). These populations were found to have similar gestational ages, Dubowitz scores at birth, and head circumferences. Conclusions: These findings suggest that processes retated to intrauterine growth restriction or perinatal acid-base balance are related to the occurrence of NRH, and support the observation that later development in life may be a~ered in these infants.