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EVALUATION OF FETAL LUNG MATURITY BY A METHOD OF AMNIOTIC FLUID LAMELLAR BODIES
Oleg Petrović
; Klinika za ginekologiju i porodništvo, Klinički bolnički centar Rijeka
Mirko Prodan
; Klinika za ginekologiju i porodništvo, Klinički bolnički centar Rijeka
Aleks Finderle
; Klinika za ginekologiju i porodništvo, Klinički bolnički centar Rijeka
Sanja Zaputović
; Klinika za ginekologiju i porodništvo, Klinički bolnički centar Rijeka
Robert Krajina
; Klinika za ginekologiju i porodništvo, Klinički bolnički centar Rijeka
Elizabeta Fišić
; Zavod za laboratorijsku dijagnostiku, Klinički bolnički centar Rijeka
Božena Beljan
; Zavod za laboratorijsku dijagnostiku, Klinički bolnički centar Rijeka
Sažetak
In cases of iatrogenic premature delivery, previous fetal lung maturity testing is often required. Therefore, the aim of this study was to investigate diagnostic and prognostic values of lamellar body counts (LBCs) in the amniotic fluid in the assessment of fetal/neonatal lung maturity and neonatal outcome, and to determine cut-off value of the LB concentrations as accurate predictor of newborn's lung maturity. Samples of the amniotic fluid were obtained by amniocentesis from 115 pregnant women with singleton pregnancy (total of 155 tests) and from 17 twin pregnancies (total of 30 fetuses and 33 tests), and then noncentrifuged specimens were analysed on LBs in the electronic blood cell counter. Normal or mild disorder of respiratory function after birth was found in 108 newborns, while LBCs in the amniotic fluid widely ranged from 4,000/µL to 384,000/µL. The lowest LBC in the amniotic fluid in term pregnancies (more or 37 weeks) amounted to 15,000/µL. Two newborns had a moderate and other five had a severe form of acute respiratory distress syndrome (amniotic fluid LBCs ranged from 1,000/µL to 4,000/µL). In two newborns, despite measures of intensive treatment, deadly outcome followed. In the group of 17 twin pregnancies, normal respiratory status after delivery was found in 29 babies, and LBCs in the amniotic fluid varied from 16,000/µL to 149,000/µL, not strongly depending on gestational age. Only one twin baby at the 28th week of gestation with LB count of 5,000/µL died due to a severe and resistant respiratory distress. The authors concluded that LBCs in the amniotic fluid >25,000/µL strongly suggest the maturity of fetal lungs and absence of respiratory disorders after birth. In contrast, LB counts <5,000/µL of the amniotic fluid point to a high risk of moderate and severe neonatal respiratory disorders. On the basis of their own results, the authors claim that the mentioned method as an efficient, highly reproducible, simple, rapid and cheap antenatal quantitative test for determining fetal lung maturity should be a method of choice in daily diagnostic perinatal practice.
Ključne riječi
lamellar bodies; amniotic fluid; amniocentesis; fetal lung maturity; neonatal respiratory status
Hrčak ID:
23858
URI
Datum izdavanja:
1.9.2006.
Posjeta: 2.774 *