Evaluation of diagnostic value of lamellar body counts (LBC) in amniotic fluid for diagnosis of neonatal respiratory distress syndrome (RDS) in pregnancy termination at 28-40 gestational weeks

Document Type : Original Article

Authors

1 Associate Professor, Department of Obstetrics and Gynecology, Women's Health Research center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Associate Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Resident of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Respiratory distress syndrome (RDS) due to lack of enough surfactant in fetal lung tissue is one of the common causes of neonatal mortality. There are several laboratory methods to determine the amount of fetal lung surfactant. The purpose of this study is to assess the lamellar body count for prediction of the amount of pulmonary surfactant for diagnosis of neonatal respiratory distress syndrome in premature neonates.
Method: This cross-sectional and applied study was performed on 91 infants with gestational age between 28-40 weeks for 6 months in 2013. In this study, lamellar body count test was performed for all infants. Lamellar body count was performed by a cell counter (Sysmex model K-X21). ROC Curve was also used for data analysis.
Results: Among 91 samples, 14 cases (15.4%) had respiratory distress syndrome. There were significant relationship between the prevalence of respiratory distress and gender (P=0.05), gestational age (P=0.01) and neonatal weight (P=0.01). The best cut off point for lamellar body count was less or more than 22500. Also, sensitivity, specificity, positive and negative predictive values were 94.7%, 100%, 100% and 94.7%, respectively.
Conclusion: Lamellar body count is a useful test for screening in terms of neonatal pulmonary surfactant. The test has appropriate sensitivity and specificity in the diagnosis of respiratory distress syndrome.

Keywords

References

  1. American College of Obstetriciansand Gynecologists. Assessment of fetal lung maturity. ACOG technical bulletinno. Washington, DC: American College of Ob-stetriciansand Gynecologists; 1996.
  2. Luo G, norwitze ER. Revisitinig amniocentesis for fetal lungmaturity after 36 weeks gestation. Rev Obstet Gynecol 2008; 1(2):61-8.
  3. Zanardo V, simbia AK, Franzoi M, Solda G, Salvadoria A, Trevisanuto D. Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesare and delivery. Acta Paediatr 2004; 93(5):643-7.
  4. Visnjevac J, Mikić AN, Nikolić A, Visnjevac N. [Comparative analysis of amnioticfluid lamellar body count and foam stability test as indices of fetal lung maturity]. Med Pregl 2010; 63(11-12):747-52.
  5. McDonald CL, Ainsworth SB. An update on the use of surfactant in neonates. Curr Paediatr 2004; 14(4):284-9.
  6. Alan HJ. Lung development and maturation. In: Martin RJ, Fanaroff AA, Walsh MC. Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 9th ed. Philadelphia: Elsevier Mosby; 2011. p. 1075-115.
  7. Goldsmith JP, Karotkin E. Assisted Ventilation of the Neonate. 5th ed. New York, USA: Elsevier Health Sciences; 2011. p. 371-8.
  8. Kirpalani H, Moore AM, Perlman M. Residents Handbook of Neonatology. 3rd ed. Pmph, USA: Bcdecker Inc; 2006.
  9. Kirvas S. Amniotic fluid lamellar body count and phospholipids in fetal lung maturity assessment. 2014; Available at: URL: http://hdl.handle.net/10138/42549.accssed oct 27, 2014.
  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; 97(2):305­9.
  11. WijnbergerLD, Huisjes AJ, Voorbij HA, Franx A, Bruinse HW, Mol BW. The accuracy of lamellar body count and lecithin/sphingomyelin ratio in the prediction of neonatal respiratory distress syndrome: a meta­analysis. BJOG 2001; 108(6):583­8.
  12. Lewis PS, Lauria MR, Dzieczkowski J, Utter GO, Dombrowski MP. Amniotic fluid lamellar body count: cost-effective screening for fetal lung maturity. Obstet Gynecol 1999; 93(3):387-91.
  13. 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 2010; 281(1):15-21.
  14. American College of Obstetricians and Gynecologists. ACOG educational bulletin. Assessment of fetal lung maturity. Int J Gynecol Obstet 1997; 56(2):191­8.
  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; 14(6):373­82.
  16. Lee IS, Cho YK, Kirn A, Min WK, Kirn KS, Mok JE. Lamellar body count in amniotic fluid as a rapid screening test for fetal lungmaturity. J Pernatol 1996; 16(3 Pt 1):176-80.
  17. 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 non-diabetic pregnant women. Arch Gynecol Obstet 2005; 271(4):325-8.
  18. Grenache DG, Gronowski AM. Fetal lung maturity. Clin Biochem 2006; 39(1):1-10.
  19. Bahasadri S, Changizi N. Amniotic Fluid Lamellar Body Count: A Predictor of Respiratory Distress in Newborns. Iran J Obstet Gynecol Infertil 2010; 13(5):8-12.
  20. Babaei H, Sadeghi N, Rezaei M. Comparative study of diagnostic value of gastric aspirate shakes test & lamellar body count for prediction of lung maturity in premature neonates. Sci J Kurdistan Univ Med Sci 2013; 18(4):8-17.
  21. Fields M, Towers CV, Howard BC, Hennessy MD, Wolfe L, Weitz B, et al. Accuracy of the lamellar body count in amniotic fluid contaminated by meconium. J Matern Fetal Neonatal Med 2015; 28(2):146-8.
  22. Khazardoost S, Yahyazadeh H, Borna S, Sohradvand F, Yahyazadeh N, Amini E. Amniotic fluid lamellar body count and its sensitivity and specificity in evaluation of fetal lung maturity. J Obestet Gynecol 2005; 25(3):257-9.
  23. Abd El Aal DE, Elkhirshy AA, Atwa S, El-Kabsh MY. Lamellar body count as a predictor of neonatal lung maturity in high-risk pregnancies. Int J GynaecolObstet 2005; 89(1):19-25.
  24. Haymond S, Luzzi VI, Parvin CA, Gronowski AM. A direct comparison between lamellar body counts and fluorescent polarization methods for predicting respiratory distress syndrome. Am J Clin Pathol 2006; 126(6):894-9.
  25. Hosseini MB, Haidarzadeh M, Taghavi S, Golzar A. Predictive value of amniotic fluid lamellar body count in easy and rapid evaluation of fetal lung maturity. Proceeding of the 20th International Conference on Pediatric Diseases and the 6th Pediatric Nursing Symposium Iran. Thehran, Iran: Imam Khomeini Hospital; 2008 Oct 9-12.
  26. Tsuda H, Kotani T, Sumigama S, Kawabata I, Takahashi Y, Iwagaki S, et al. Validity of lamellar body count as a fetal lung maturity assessment in twin pregnancy. Twin Res Hum Genet 2012; 15(4):547-9.
  27. Chaudhari R, Deodhar J, Kadam S, Bavdekar A, Pandit A. Gastric aspirate shake test for diagnosis of surfactant deficiency in neonates with respiratory distress. Ann Trop Paediatr 2005; 25(3):205-9.
  28. Roiz-Hernández J, Navarro-Solis E, Carreón-Valdéz E. Lamellar bodies as a diagnostic test of fetal lung maturity. Int J Gynaecol Obstet 2002; 77(3):217-21.
  29. Tsuda H, Takahashi Y, Iwagaki S, Uchida Y, Kawabata I, Hayakawa M, et al. Amniotic lamellar body counts can predict the occurrence of respiratory distress syndrome as well as transient tachypnea of the newborn (TTN). J Perinat Med 2011; 39(3):245-50.
  30. Behrman R, Kliegman RM, Jenson H, Stanton B. Nelson text book of pediatrics. 6th ed. St Louis: Saunders Elsevier; 2012.

Files

Share

How to cite

Statistics