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LAMELLAR BODY COUNTS: A CONSENSUS ON PROTOCOL

From the Departments of Obstetrics and Gynecology and Laboratory Medicine, Northwestern University Medical School, Evanston Northwestern Healthcare, Evanston, Illinois; University of Utah School of Medicine, Salt Lake City, Utah; the College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; and the Second Institute of Gynecology and Obstetrics, "La Sapienza" University, Rome, Italy.

Address reprint requests to: M. G. Neerhof, DO Evanston Northwestern Healthcare 2650 Ridge Avenue Evanston, IL 60201 E-mail: m-neerhof{at}northwestern.edu

Lamellar bodies, concentrically layered "packages" of phospholipid that represent the storage form of surfactant, can be counted in the platelet channel of most electronic cell counters. The lamellar body count has been used for more than a decade and performs as well as traditional phospholipid analysis as an assay for evaluating fetal lung maturity. It is preferable to phospholipid analysis because it is rapid, objective, and inexpensive and can be performed in any hospital laboratory. The current methodologies for specimen preparation vary widely among laboratories, most notably with respect to centrifugation, resulting in differences in maturity cutoffs used. Our goal was to establish a consensus regarding a standardized methodology for the lamellar body count. Institutions that previously had published their results with lamellar body counts were invited to contribute. The consensus of the four participating institutions includes the following: centrifugation is not a necessary step and should be abandoned, maturity is suggested by a count of 50,000/µL or greater, and immaturity is suggested by a count of 15,000/µL or lower. As the lamellar body count gains wider acceptance as a primary assay for assessing fetal lung maturity, the test must be performed uniformly and accurately, given the implications of acting on a falsely negative test resulting from improper methodology.

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