Lamellar body count as a diagnostic test in predicting neonatal respiratory distress syndrome.

AIM: To determine the lamellar body count (LBC) cutoff value for fetal lung maturity and to evaluate the clinical usefulness of LBC in predicting the severity of neonatal respiratory distress syndrome (RDS). METHODS: A prospective study was conducted from 2002 until 2010. LBC was estimated in uncentrifugated amniotic fluid samples using Cell-Dyn 1800 analyzer. Amniotic fluid samples were obtained by amniocentesis or by puncturing embryonic membranes during cesarean section. The presence of mild, moderate, and severe RDS was assessed by neonatologist. RESULTS: A total of 313 patients with singleton pregnancies (24-41 weeks) were included in the study and 294 met the inclusion criteria. RDS was diagnosed in 28 neonates - mild in 8, moderate in 10, and severe in 10. In premature neonates (<37 gestational weeks), significant differences in LBC were only found between the subgroup without RDS and the group with moderate and the group with severe RDS (P<0.001). In all neonates, significant differences were found between neonates without RDS and neonates with RDS. Using LBC cutoff value of ≥20,000/µL, sensitivity, specificity, and positive and negative predictive values of LBC in determining mature fetal lungs were 96%, 88%, 45.6%, and 99.5%, respectively. CONCLUSION: This study suggests that LBC cutoff value of ≥20,000/µL can predict pulmonary maturity and reduce the risk of neonatal respiratory distress syndrome.

The influence of pre-eclampsia on fetal lung maturity.

OBJECTIVE: To use amniotic fluid (AF) lamellar body count (LBC) to assess the influence of pre-eclampsia and associated pathologic conditions on fetal lung maturity (FLM). METHODS: A prospective study was conducted to analyze 378 AF samples containing 5 mL of AF from 306 singleton pregnancies at 26-39 weeks. Stratified by gestational age groups, pregnancies were categorized as follows: pre-eclampsia (n=25); intrauterine growth restriction (IUGR) (n=74); pre-eclampsia and IUGR (n=63); and control (n=144). Amniotic fluid LBC in each group was estimated and medians were compared for defined gestational age periods. Statistical analyses were performed via non-parametric tests. RESULTS: Between 31 and 33 weeks, significantly lower median LBCs were found in the pre-eclampsia group than in the IUGR group (P=0.022) and in pregnancies with both entities (P=0.031). Between 34 and 36 weeks, there were significantly lower median LBCs in the pre-eclampsia and the pre-eclampsia/IUGR groups than in the IUGR group (P=0.026 and P=0.004, respectively), as well as in the pre-eclampsia/IUGR group compared with the control group (P=0.04). CONCLUSION: Significantly lower LBCs in pre-eclamptic pregnancies between 31 and 36 weeks of gestation indicate delayed FLM associated with pre-eclampsia.

Fetal ultrasound biometry for pregnant population in the County of Primorje-Gorski Kotar (Croatia).

OBJECTIVE: To create curves of three most commonly used biometric parameters for singleton pregnancies from 22 to 41 weeks of gestation in the County of Primorje-Gorski Kotar (Croatia) and to compare results with other studies. METHODS: From January 2002 to December 2009, ultrasound examination was performed on fetuses of 1248 pregnant women with uncomplicated pregnancy. Values for biparietal diameter, femur length, and fetal abdominal circumference were measured. Results were compared with studies pertaining to European and North American population. Mean, percentile scale, and Wilcoxon's matched pairs test were used. Regression analysis was applied to analyze data correlation and to determine correlation quotients. RESULTS: Total of 2178 measurements for fetal biometry charts were performed. Established mean and centile values for fetal biometry parameters are reported numerically and graphically. Comparison of obtained values with values of identical fetal biometric parameters of other world populations has revealed statistically significant differences (p < 0.01). CONCLUSION: Normal fetal biometry charts for population of pregnant women in the northern coastal region of Croatia were constructed. Due to existence of statistically significant differences in ultrasound fetal biometry values among various populations under comparison, construction of own charts and their implementation in routine obstetrical work are justified.

[Regionalization of neonatal intensive care. Results and experience at the Department of Gynecology and Obstetrics of Rijeka University Hospital]. / Regionalizacija neonatalnog intenzivnog lijecenja. Rezultati i iskustva Klinike za ginekologiju i porodni tvo KBC-a Rijeka.

OBJECTIVE: To analyse mortality of extremely low (ELBW) and very low (VLBW) birth weight nawborns at the Department of Gynecology and Obstetrics of Rijeka University Hospital, before, during and after implementing a model of regionalization of perinatal care. In Croatia this model is still not established so the results can help us evaluate whether the suggested model is practicable and whether its appliance decrease newborns' mortality. PATIENTS AND METHODS: We compared early neonatal mortality (RNM), neonatal mortality (NM) and intrahospital mortality (MOB) of ELBW and VLBW newborns at the pediods before (1997-2000), during (2000-2001) and after (2003-2006) the implemented changes. RESULTS: RNM was significantly lowered for both weight groups, but NM and MOB only for VLBW newborns. CONCLUSION: Our results show that appliance of regionalization of perinatal care is possible and unquestionable on local level, so it should be implemented on national level too.