Contemporary Issues In Fetal Lung Maturity Testing

David Grenache, PhD, MT(ASCP), DABCC, FACB

September 2009

   Q&A Archive


Testing for lung maturity is important in management of premature labor, hemolytic disease of the newborn, premature rupture of membranes, and any other clinical situations in which early delivery of the fetus would be considered. The results of these tests are used to determine whether to attempt to suppress labor or to induce delivery. If a neonate is delivered before the lungs have had time to fully mature, neonatal respiratory distress syndrome (RDS, also called hyaline membrane disease) may result. 

In this presentation, Dr. Grenache describes the pathophysiology and treatment of neonatal RDS; compares and contrast the different types of fetal lung maturity (FLM) tests, including surfactant/albumin ratio, PG by agglutination and thin-layer chromatography, lecithin/sphingomyelin ratio, and lamellar body count; discusses the clinical utility of the various FLM methods; and reviews current issues facing labs that employ fetal lung maturity tests. 



Dr. Grenache is an Assistant Professor of Pathology at the University of Utah Health Sciences Center and the Medical Director of the Special Chemistry laboratory at ARUP Laboratories in Salt Lake City, Utah. Dr. Grenache received his BA in Biology and BS in Medical Technology from the Massachusetts College of Liberal Arts in North Adams, MA, and his PhD in Biomedical Sciences from Worcester Polytechnic Institute in Worcester, MA. He completed his postdoctoral training in clinical chemistry at Washington University School of Medicine in St. Louis, MO.

A member of AACC since 1994, Dr. Grenache has served in a number of capacities including chair of the North Carolina local section, chair of the Society for Young Clinical Laboratorians, member of the two Annual Meeting Organizing Committees, and chair of the National Membership Committee. He currently serves on the board of editors of Clinical Laboratory News and is the delegate for the Rocky Mountain local section. Dr. Grenache is a diplomate of the American Board of Clinical Chemistry and serves on its board of directors. He is also a fellow of the National Academy of Clinical Biochemistry.

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