Amniotic Fluid Lamellar Body Count as a Predictor of Fetal Lung Maturity.

Assessment of fetal lung maturity can be done with various biochemical tests on amniotic fluid. In the present study, lamellar body count (LBC) was compared with the traditional shake bubble test (SBT), as LBC is a simple, reliable and cost-effective method to predict fetal lung maturity. This was a prospective study conducted on 50 patients with known last menstrual period (LMP), gestational age >28 weeks presenting in active phase of labor with intact membranes. Amniotic fluid was collected either through vaginal route or through amniocentesis and SBT and LBC were conducted on all samples. Newborns were watched for signs of respiratory distress syndrome (RDS). Fourteen babies developed RDS. i.e., one out of 34 babies with positive SBT, seven out of 10 with intermediate SBT, all six with negative SBT developed RDS. The LBC varied between 3,000-28,000/ml among the 14 babies with RDS. i.e., all cases with RDS had LBC <30,000/ml. This study showed that LBC with cut-off value of 30,000/ml to predict fetal lung maturity is superior to all other tests in terms of technique and cost-effectiveness.

The Efficacy of Lamellar Body Counts for Prediction of Perinatal Outcome / 대한산부인과학회잡지

OBJECTIVE: This study is aimed to evaluate whether lamellar body count (LBC) in amniotic fluid could be used as a predictor of neonatal morbidity as well as respiratory distress syndrome (RDS) and to determine the value of lamellar body count that maximizes sensitivity and specificity. METHODS: We conducted a prospective clinical outcome study. Amniotic fluid was obtained from 39 pregnant women at various gestational ages (29 to 36 weeks) from March 1, 2002 to February 28, 2003. They delivered within 72 hours of amniocentesis, excluding 6 cases of contaminated amniotic fluid. A LBC was performed on each specimen. The frequencies of RDS, minor and major morbidity of newborn in different LBC cutoff value were analyzed. Statistic analysis was done by Chi-square test. RESULTS: LBCs increased with gestation (r=0.533, p<0.05). The LBC cutoff value that best agreed with RDS (sensitivity 36.4%, specificity 93.8%), minor morbidity (sensitivity 100.0%, specificity 50.0%) and major morbidity (sensitivity 45.5%, specificity 81.3%) was 30,000/ l. CONCLUSION: These results indicate that LBC might be useful as a predictor of neonatal morbidity as well as respiratory distress syndrome.

The clinical efficacy and cost-effectiveness of Lamellar body count in fetal lung maturation test / 대한산부인과학회잡지

OBJECTIVE: To evaluate the availability and efficacy of the Lamellar body count as a predictor of fetal lung maturity METHODS: Amniocentesis was performed for evaluation of fetal lung maturity status within 72 hours of delivery in 32 patients. A Lamellar body count in clean amniotic fluid (AF) was analyzed right after amniocentesis. In case of contaminated AF with meconium or blood, samples was centrifuged for 3 minutes and divided into three. The average of three samples was analyzed successively from Coulter counter. RESULTS: The incidence of RDS showed significant relation with gestational age, 1-minute and 5-minute Apgar Score. Using a value greater than 30,000/ l to indicate pulmonary maturity, the Lamellar body count predicted all lung-maturated cases with no false-negative results (100% negative predictive value). All 4 cases of RDS demonstrated Lamellar body count less than 30,000/microl. By using a lower cutoff of 10,000/microl to predict pulmonary immaturity. Positive predictive value was 100% in RDS patients. CONCLUSION: In high risk pregnancy, fetal lung maturity test from amniotic fluid lamellar body count is a rapid, simple and reliable method in making a decision of delivery-time. And also it has universal availability with cost-effectiveness when we consider the reality of korean medical situation

The Clinical Efficacy of Lamellar Body Count to Predict Fetal Lung Maturity / 대한산부인과학회잡지

From July 1994 through August 1995, 31 patients who delivered before 37 weeks gestation at the Ajou University Hospital were tested for lamellar body count in the amniotic fluid. The obtained results are summarized as follows; 1. Lamellar body count was associated with 1 minute Apgar score(p=0.02). 2. There was no sexual, gestational and birth weight differences in the incidence of respiratory distress syndrome. 3. Lamellar body count showed that the positive predictive value for respiratory distress syndrome was 90.0 %, the negative predictive value was 95.2 %, and the sensitivity was 90.0 %, and the specificity was 95.2 %, therefore it may be regarded as more accurate than other previously employed methods. This study suggests that the lamellar body count reflects fetal lung maturity sufficiently to assure that the neonate will not develop respiratory distress syndrome, and can be used as a quick screening test or one in series of tests for thorough assessment of fetal lung maturity.