Seventy-two amniocenteses with concurrent placental grading by ultrasound were performed during 66 pregnancies. No relationship was observed between placental grade and the mean ratio of lecithin to sphingomyelin (L/S) or the phosphatidylglycerol concentration. Both placental grade and fetal lung maturity were interrelated by the independent variable of gestational age. The latter may explain the trend observed between a mature L/S ratio and the placental grade. Grade 3 placentas were present in only 20% of patients studied at 37 weeks of gestation or later (12 of 61 patients), and in every instance a Grade 3 placenta was associated with an absence of neonatal respiratory distress.