Amniotic Fluid Lamellar Body Count: A Predictor of Respiratory Distress in Newborns

Document Type : Original Article

Authors

1 Assistant Professor of Obstetrics & Gynecology, Iran University of Medical Sciences, Tehran, Iran

2 Resident of Obstetrics & Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Assessment of fetal lung maturity by a simple and rapid test has a pivotal role in obstetric managements. Considering lack of modern laboratory techniques in Iran This study was designed to investigate lamellar body count as an efficient method in evaluation of fetal lung maturity.
 
Methods: Lamellar body count was assessed in 104 unspun amniotic fluid samples taken from pregnant women who referred to Akbarabadi hospital in year 2004 whose fetuses were at risk for respiratory distress syndrome. Sysmex K.800 was used to count lamellar bodies. Cut-off points for Lamellar body count were determined to evaluate the risk of respiratory distress syndrome. Standard clinical and radiographic criteria were used to diagnose respiratory distress syndrome. Sensitivity, specificity, positive and negative predictive values were calculated using SPSS11.
 
Results: Lamellar body count of less than 10,000 was 99.1% specific for lung immaturity (positive predictive value = 99.1%, negative predictive value = 83.5%). Lamellar body count of greater than 45,000 eliminated respiratory distress syndrome (negative predictive value = 98.9%).
 
Conclusion: Lamellar body count is an easy, rapid and cost-effective test to assess fetal lung maturity in high-risk fetuses. Using the cut-off points of 10,000 and 45,000, lamellar body count can serve as the first screening test of fetal lung maturity.

Keywords

References

1. Dubin S B. Characterization of amniotic fluid lamellar bodies by resistive­pulse counting: relationship to  measures of fetal lung maturity. Clin Chem 1989 Apr;35(4): 612­16.
2. Lewis  PS, Lauria MR, Dzieczkowski J, Utter GO. Amniotic fluid lamellar body count: cost­effective  screening for fetal lung maturity. Obstet Gynecol 1999 Mar;93(3):387­91.
3. Beinlich A, Fischass C, Kaufmann M, Schlosser R, Dericks­Tan JS. Lamellar body counts in amniotic fluid 
for prediction of fetal lung maturity. Arch Gynecol Obstet 1999;262(3­4):173­80.
4. Dalence C R, Bowie LJ, Dohnal JC, Farrel EE, Neerhof MG. Amniotic fluid lamellar body count: a rapid 
and reliable fetal lung maturity test. Obstet Gynecol 1995 Aug;86(2):235­39.
5. Hernandez JR, Solis EN, Valdez EC. Lamellar body as a diagnostic test of fetal lung maturity. Int J 
Gynecol Obstet 2001;77: 17­21.
6. Fakhoury G, Daikoku NH, Benser J, Dubin NH. Lamellar body concentrations and the prediction of fetal
pulmonary maturity. Am J Obstet Gynecol 1994 Jan;170(1Pt 1):72­76.
7. Ashwood ER, Palmer SE, Taylor JS, Pingree SS. Lamellar body counts for rapid fetal lung maturity testing. Obstet Gynecol 1993 Apr;81(4):619­24.
8. 8. Lee IS, Cho YK, Kim A, Min WK, Kim KS, Mok JE. Lamellar body count in amniotic fluid as a rapid  screening test for fetal lung maturity. J Pernatol 1996 May­Jun;16(3Pt 1):176­80.
9. Piazze JJ, Anceschi MM, Brancato V, Cosmi EV. Testing for fetal lung maturity. Inter J Gynecol Obstet
1997 Dec;59(3):255­6.
10. Neerhof MG, Haney EI, Silver RK, Ashwood ER, Lee IS, Piazzze JJ. Lamellar body counts compared with 
traditional phospholipid analysis  as an assay for evaluating fetal lung maturity. Obstet Gynecol 2001 
Feb;97(2):305­9.
11. Wijnberger LD, Huisjes AJ, Voorbij HA, Franx A, Bruinse HW. The accuracy of lamellar body count and 
lecithin/sphingomyelin ratio in the prediction  of neonatal respiratory distress syndrome: a meta­analysis. BJOG 2001 Jun;108(6):583­8.
 
12. ACOG educational bulletin. Assessment of fetal lung maturity. Number 230, November 1996. Committee  on Educational Bulletins of the American College of Obstetricians and Gynecologists. Int J Gynecol Obstet
1997 Feb;56(2):191­8.
13. 13. Richardson  DK, Heffner LJ.  Fetal­lung maturity: tests mature, interpretation  not. Lancet 2001  Sep 
1;358(9283):684­6.
14. Ghidini A, Poggi SH, Spong CY, Goodwink KM, Vink J, Prezzullo JC. Role of lamellar body count for
the prediction  of neonatal respiratory distress syndrome  in non­diabetic pregnant women. Arch  Gynecol
Obstet 2005 Apr;271(4):325­8.
15. Wijnberger LD, de Kleine M, Voorbij HA, Arabin B, van de Leur JJ, Bruinse HW, et al. The effect of clinical characteristics on the lecithin/sphingomyelin ratio and lamellar body count: a cross­sectional study. J Matern Fetal Neonate Med 2003 Dec;14(6):373­82.
16. Abd EI, Aal De, Elkhirsky AA, Atwa S, El­Kabsh MY. Lamellar body count as a predictor of neonatal
lung maturity in high­risk pregnancies. Int J Gynecol Obstet 2005 Apr; 89(1):19­25.
17. Ljubić V, Radunović N, Stefanović A, Opalić J. [Quantitative analysis of lamellar bodies in amniotic fluid  as fetal pulmonary maturity indicator] [Article in Serbian]. Vojnosanit Pregl 2009 Feb;66(2):113­5.
18. Wijnberger LD, de Kleine M, Voorbij HA, Arabin B, Bruinse HW, Visser GH, et al. Prediction of fetal
lung immaturity using gestational age, patient characteristics and fetal lung maturity tests: a probabilistic  approach. Arch Gynecol Obstet 2009 Apr 19.
19. Janicki MB, Dries LM, Egan JF, Zelop CM. Determining a cutoff for fetal lung maturity with lamellar body  count testing. J Matern Fetal Neonatal Med 2009 May;22(5):419­22.

Files

Share

How to cite

Statistics