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

Autor: Robert Krajina, Mirko Prodan, Lidija Bilić-Zulle, Oleg Petrović, Tea Štimac
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Adult
medicine.medical_specialty
Pediatrics
Neonatal respiratory distress syndrome
Amniotic fluid
Adolescent
Gestational Age
Lamellar granule
Sensitivity and Specificity
Severity of Illness Index
Statistics
Nonparametric
Young Adult
Meconium
Predictive Value of Tests
Pregnancy
medicine
Humans
Prospective Studies
Lung
Respiratory Distress Syndrome
Newborn
Chi-Square Distribution
Respiratory distress
Obstetrics
business.industry
Diagnostic Tests
Routine
BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Ginekologija i opstetricija
BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Gynecology and Obstetrics
Infant
Newborn
Gestational age
Pulmonary Surfactants
General Medicine
prediction
Clinical Science
medicine.disease
Amniotic Fluid
lamellar body count
cutoff value
Predictive value of tests
Female
Lamellar body count
business
Zdroj: Croatian Medical Journal
Volume 53
Issue 3
Croatian medical journal
ISSN: 0353-9504
1332-8166
Popis: Respiratory distress syndrome (RDS) occurs in infants delivered before the completion of fetal lung maturation and remains a major cause of neonatal morbidity and mortality in premature infants (1). RDS affects approximately 1% of all live births, but 10 to 15% of all infants with a birth weight less than 2500 g (2). The risk of RDS is increased with prematurity, but is also significant in infants born by electively scheduled cesarean delivery between 38 and 39 weeks of gestation (3). Therefore, the American College of Obstetricians and Gynecologists recommends the documentation of fetal lung maturity for elective deliveries at less than 39 weeks of gestation to avoid neonatal RDS (4). There are several antenatal tests for lung maturity. Evaluation is commonly based on laboratory measurements of the concentrations of particular components of pulmonary surfactant (4-7). Most of them are either complex, expensive, or with low diagnostic efficiency (8). Amniotic fluid lamellar body count (LBC) is one among various biophysical tests, based on measuring the concentration of pulmonary surfactant in amniotic fluid (9). Lamellar bodies (LB) are storage form of surfactant within type II pneumocytes and are actively secreted into the alveolar space and hence into the amniotic fluid (4). The size of LBs, similar to platelets, permits the use of a standard hematologic counter to quantify LB concentration in amniotic fluid samples. This technique quantitatively estimates surfactant production and thus can predict the degree of fetal lung maturation. Still, there are no clearly established protocols and cutoff values for LBC that predict RDS (4). The maturity thresholds for LB vary due to different factors, ie, centrifugation (leads to substantial loss of the LBs), sample contamination (meconium or platelets from the blood can be counted as LBs), and sample type (vaginal pool specimen containing mucus can artificially increase the LBC) (10,11). Depending on the protocols, the cutoff values of LBC that predict the absence of neonatal RDS can vary from 15 000 to even 80 000/µL (4,10,11). Also, the type of particle count analyzer used is critical in setting the cutoff values, so it has been proposed to establish analyzer-specific references for LBC (1). The aim of our investigation was to evaluate the LBC cutoff value using Cell-Dyn 1800 analyzer (Abbott Diagnostics, Abbott Park, IL, USA) and evaluate the efficiency in predicting different grades of neonatal RDS.
Databáze: OpenAIRE
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