HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by LEWIS, P. S. Articles by DOMBROWSKI, M. P. Search for Related Content PubMed PubMed Citation Articles by LEWIS, P. S. Articles by DOMBROWSKI, M. P.

Amniotic Fluid Lamellar Body Count: Cost-effective Screening for Fetal Lung Maturity

From the Departments of Obstetrics and Gynecology, Pathology, and Internal Medicine, Wayne State University, Hutzel Hospital, and the Department of Obstetrics and Gynecology, Grace Hospital, and St. John Hospital and Medical Center, Detroit, Michigan.

Address reprint requests to: Pamela S. Lewis, MD, Hutzel Hospital, Department of Maternal Fetal Medicine, 4707 St. Antoine Boulevard, Detroit, MI 48201, E-mail: plewis{at}med.wayne.edu

Objective: To create a highly specific cascade testing scheme for fetal lung maturity using the lamellar body count, lecithin/sphingomyelin ratio (L/S), and phosphatidylglycerol.

Methods: A nondedicated hematology analyzer (Sysmex NE 1500, Toa Medical Electronics, Los Angeles, CA) was used to determine the lamellar body counts of 209 unspun amniotic fluid specimens. Maximally specific lamellar body count cutoffs for biochemical maturity and immaturity were determined using receiver operating characteristic curves. Biochemical lung maturity was defined as either a mature L/S ratio or phosphatidylglycerol. Biochemical lung immaturity was defined as both an immature L/S ratio and an immature phosphatidylglycerol.

Results: A lamellar body count of less than 8000 (n = 17) was 100% specific for biochemical lung immaturity (positive predictive value = 100%, negative predictive value = 86%). A lamellar body count of greater than 32,000 was 98% specific for biochemical lung maturity (positive predictive value = 99%, negative predictive value = 63%).

Conclusion: Testing only specimens where the lamellar body count was greater than 8000 and less than or equal to 32,000 for the L/S ratio and phosphatidylglycerol would preclude the need for 76% of all L/S and phosphatidylglycerol assays. Because the lamellar body count is quick, simple, and universally available, it could serve as an extremely cost-effective screening test for fetal lung maturity.

This article has been cited by other articles:

				A. Szallasi, A. M. Gronowski, and C. S. Eby Lamellar Body Count in Amniotic Fluid: A Comparative Study of Four Different Hematology Analyzers Clin. Chem., June 1, 2003; 49(6): 994 - 997. [Full Text] [PDF]

				C. R. Fantz, C. Powell, B. Karon, C. A. Parvin, K. Hankins, M. Dayal, Y. Sadovsky, V. Johari, F. S. Apple, and A. M. Gronowski Assessment of the Diagnostic Accuracy of the TDx-FLM II to Predict Fetal Lung Maturity Clin. Chem., May 1, 2002; 48(5): 761 - 765. [Abstract] [Full Text] [PDF]

				M. G. NEERHOF, E. I. HANEY, R. K. SILVER, E. R. ASHWOOD, I.-S. LEE, and J. J. PIAZZE Lamellar Body Counts Compared With Traditional Phospholipid Analysis as an Assay for Evaluating Fetal Lung Maturity Obstet. Gynecol., February 1, 2001; 97(2): 305 - 309. [Abstract] [Full Text] [PDF]

				M. G. Neerhof, J. C. Dohnal, E. R. Ashwood, I.-S. Lee, and M. M. Anceschi LAMELLAR BODY COUNTS: A CONSENSUS ON PROTOCOL Obstet. Gynecol., February 1, 2001; 97(2): 318 - 320. [Abstract] [Full Text] [PDF]

				B. W. J. Mol, A. Huisjes, A. Franx, and P. S. Lewis AMNIOTIC FLUID LAMELLAR BODY COUNT: COST-EFFECTIVE SCREENING FOR FETAL LUNG MATURITY Obstet. Gynecol., September 1, 1999; 94(3): 481 - 482. [Full Text] [PDF]