Phosphatidylglycerol is a minor constituent of surfactant that generally appears

several weeks after the increase in lecithin concentration. Because PG enhances the
spread of phospholipids on the alveolar surface, its presence indicates an advanced
state of fetal pulmonary maturity. This test measures the level of
phosphatidylglycerol in amniotic fluid. This test is used to evaluate and manage the
lung maturity, or how well-developed the lungs are, of an unborn baby. This test
may also be used in high risk pregnancies to help predict if an unborn baby's lungs
are mature before the baby is born. An advantage of PG determination in assessing
fetal maturity is the fact that blood, meconium, or other contaminants do not
generally affect it. This characteristic allows PG determination by using vaginal pool
samples from patients who have spontaneous rupture of membranes. A
disadvantage of using PG for assessing fetal maturity is its relatively late
appearance in pregnancy.
Phosphatidylglycerol determination can be accomplished by either thin-layer
chromatography or by slide agglutination. A pregnant woman may need this test if
you have:

Fetal lung development

Compared with other tests, an immature result (negative PG) is associated with a
greater proportion of infants who will not develop RDS. Presence of
phosphatidylglycerol in amniotic fluid may suggest that:

The lung is sufficiently mature and the neonate will be free of Respiratory
Distress Syndrome (RDS). In cases involving certain maternal complications,
notably diabetes mellitus, the presence of PG even with an immature L/S ratio
may suggest that the newborn will be free of RDS.

Laboratory test results may vary depending on the age, gender, health history, the
method used for the test, and many other factors. If the results are different from
the results suggested below, this may not mean that one has a disease. The
following are considered to be normal results for this test:

Pregnant women (3rd trimester):

o

Thin-layer chromatography [1][4]

Slide-agglutination test [4][1]

Absent: Fetal lung immaturity

Negative: <0.5 mg/L

Enzymatic assay: 19-83 mg/L [4]

The absence of PG with a mature L/S ratio may still suggest a substantial risk of
RDS.

Before:

It is a procedure that requires the patients written consent. Review the

consent form with the patient and ask any questions that she has before
signing the consent form.
Ask the person doing the test if she has a history of pregnancy difficulties,
such as premature (early) labor, incompetent cervix (a weak or failing cervix),
placenta previa (a placenta that is abnormally low, near or over the cervix),
abruptio placentae (the placenta is separated from the uterine wall too early),
and if you are Rh negative (had a blood type that did not match your child's
blood type).
Tell the patient if she has a medical condition or is using a medication or
supplement that causes excessive bleeding. You should also ask if she has a
history of allergic or other reactions to local anesthetics.

During:

Inform the patient to report if she feels that she cannot continue with the
procedure.
Inform the patient that she may feel mild discomfort or stinging when the
numbing medicine is injected. As the procedure needle is inserted through
the abdomen, she may feel some discomfort and pressure.
She may also feel mild cramping in her abdomen and pelvic area during the
procedure.

After:

Inform the patient that the procedure site may be sore for several days. Rest
is necessary.

Inform the patient to not have sexual intercourse, and avoid heavy lifting for
at least 24 hours after the procedure.

Inform the patient to report if there is redness, swelling, pus, drainage, or

pain at the site where the sample was taken.

Inform the patient to alert you immediately if she sees bleeding or clear fluid
leaking from her vagina, feel severe cramping in her abdominal or pelvic
area, or develop a fever.

Inform the patient to report of any change in the baby's movement, such as
not moving for a period of time, or suddenly moving more than usual after
this procedure.

A hematoma (blood-filled bump under the skin) or bleeding at the puncture

site may occur.
If she has a medical condition, or are using a medication or supplement that
causes excessive bleeding, she is at a higher risk of bleeding from the
puncture site.
It is possible that the needle that is used to collect fluid will injure the baby.
After an amniocentesis, a bruise or infection may occur at the puncture site.
She may bleed or leak amniotic fluid from the vagina.
Rarely, she may develop a fever, have severe abdominal and pelvic
cramping, or go into labor.
There is a risk that the baby will not survive the procedure. The chances of
these risks vary depending on the patients health status, the reason for
having this procedure, and other factors.

Sources:
Bak, R.S. (2001). Assessment of Fetal Lung Maturity. Retrieved September 20, 2015
from http://www.wardelab.com/12-2.html
Trofatter, K.F.Jr. (n.d). Assessing Fetal Lung Maturity - 3 - L/S Ratios and
Phosphatidylglycerol. Retrieved September 20, 2015 from
http://www.healthline.com/health-blogs/fruit-womb/assessing-fetal-lung-maturity-3ls-ratios-and-phosphatidylglycerol#2
Phosphatidylglycerol measurement, semi-quantitative, amniotic fluid. (2015,
September 4). Retrieved September 20, 2015 from
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