scholarly journals Comparative analysis of amniotic fluid lamellar body count and foam stability test as indices of fetal lung maturity

2010 ◽  
Vol 63 (11-12) ◽  
pp. 747-752 ◽  
Author(s):  
Jovana Visnjevac ◽  
Aleksandra Novakov-Mikic ◽  
Aleksandra Nikolic ◽  
Nemanja Visnjevac
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Distress Syndrome ◽  
Lamellar Body ◽  
Fetal Lung ◽  
Receiver Operating Characteristic Curves ◽  
Fetal Lung Maturity ◽  
Lung Maturity ◽  
Body Count

Introduction. Respiratory distress syndrome of the newborn caused by the fetal lung immaturity is a very serious clinical problem. Different tests of prenatal analysis of amniotic fluid, such as lamellar body count and Clements? test, are available for predicting the fetal lung maturity. Material and methods. A prospective clinical study was conducted on amniotic fluid samples from 2005 to 2006. The amniotic fluid samples were obtained at the gestational age of 30 to 42 weeks and collected by vaginal amniotomy, amniotomy during Caesarean section and 72 hours before the delivery by amniocentesis. A haematology analyzer (Nikon-Kohden?) was used to determine the lamellar body counts. Clements? test involved adding an equal volume of 96% ethanol to the multiple amniotic fluid volume (1:2, 1:4, 1:16, 1:32), followed by shaking and noting the presence of ring of bubbles. After the delivery, we compared the lamellar body count results and Clements? test and the outcome of pregnancies, primarily the development of respiratory distress syndrome. The most specific lamellar body cutoffs for maturity and immaturity were determined according to receiver operating characteristic curves. Results and Discussion. Out of 232 amniotic fluid samples which were tested, 112 samples were collected after vaginal amniotomy, 88 during the Caesarean delivery and 32 samples by amniocentesis. The overall incidence of respiratory distress syndrome was 14.6%. Receiver operating characteristic curves were used to identify cutoff points for the test. We found that both tests are good screening tests for predicting the fetal lung maturity with the area under the curve of 0.782 in Clements? test and 0.751 in the lamellar body count. Clements? cutoff 2 with sensitivity of 67.6% and specificity of 72.2%, proved best in the prediction of the fetal lung maturity. The lamellar body count cutoff of 42x10?/?l had the sensitivity of 82.4% and specificity of 64.6% in predicting the fetal lung maturity. Conclusion. Although both tests are good in predicting the fetal lung maturity, the lamellar body count has more advantages, because it is not only more objective, but also inexpensive, easy and fast to do, requires a small sample volume and is universally available.

Assay of disaturated phosphatidylcholine in amniotic fluid as a test of fetal lung maturity: experience with 2000 analyses.

1987 ◽  
Vol 33 (9) ◽  
pp. 1648-1651 ◽  
Author(s):  
M Y Tsai ◽  
E K Shultz ◽  
P P Williams ◽  
R Bendel ◽  
J Butler ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Distress Syndrome ◽  
Fetal Lung ◽  
Fetal Lung Maturity ◽  
Pooled Samples ◽  
Lung Maturity ◽  
Diabetic Mothers ◽  
Length Of Gestation

Abstract We determined concentrations of disaturated phosphatidylcholine (DSPC) in nearly 2000 amniotic fluid samples obtained either transabdominally or as vaginal pools. Here we report our comparison of these DSPC values with the lecithin/sphingomyelin (L/S) ratios for amniotic fluid samples obtained from diabetic and nondiabetic pregnancies and also between transabdominally or vaginally collected samples uncontaminated by blood or meconium. DSPC measurement is at least as good as the L/S ratio in predicting the absence of respiratory distress syndrome. DSPC concentrations were, however, lower in diabetic than in nondiabetic pregnancies, supporting the hypothesis that DSPC synthesis may be impaired in fetuses of diabetic mothers. Visually uncontaminated samples collected transabdominally or vaginally, when grouped according to length of gestation, have similar DSPC values but different L/S ratios. Thus, even in the absence of blood or meconium, DSPC may be a more useful test than the L/S ratio for vaginally pooled samples.

Multicenter evaluation of TDx test for assessing fetal lung maturity

1989 ◽  
Vol 35 (6) ◽  
pp. 1005-1010 ◽  
Author(s):  
J C Russell ◽  
C M Cooper ◽  
C H Ketchum ◽  
J S Torday ◽  
D K Richardson ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Distress Syndrome ◽  
Fetal Lung ◽  
Sample Collection ◽  
Fetal Lung Maturity ◽  
Rapid Assay ◽  
Automated Assay ◽  
Lung Maturity

Abstract "TDx Fetal Lung Maturity," an automated assay that measures the relative concentrations of surfactant and albumin in amniotic fluid, was compared with the lecithin/sphingomyelin (L/S) ratio and phosphatidylglycerol determination at five clinical sites. A total of 695 amniotic fluid samples were analyzed, of which 312 were followed by delivery of the infant within three days of sample collection. Of these 312, 24 developed respiratory distress syndrome and seven developed transient tachypnea. With the cutoff for maturity set at a surfactant/albumin value of 50 mg/g, the assay showed a sensitivity of 0.96 and a specificity of 0.88 for all samples, compared with a sensitivity of 0.96 and a specificity of 0.83 for the L/S ratio. The combination of rapid assay (30 min), accurate results, and uniformity among testing centers makes the TDx assay a very promising method.

427: Blood contaminated amniotic fluid and the lamellar body count fetal lung maturity test

2013 ◽  
Vol 208 (1) ◽  
pp. S187
Author(s):  
Kevin Visconti ◽  
Craig Towers ◽  
Mark Hennessy ◽  
Bobby Howard ◽  
Stephanie Porter ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Lamellar Body ◽  
Fetal Lung ◽  
Fetal Lung Maturity ◽  
Lung Maturity ◽  
Body Count

Predicting respiratory distress syndrome using gestational age and fetal lung maturity by fluorescent polarization

2005 ◽  
Vol 192 (1) ◽  
pp. 199-207 ◽  
Author(s):  
Curtis A. Parvin ◽  
Lawrence A. Kaplan ◽  
John F. Chapman ◽  
Timothy G. McManamon ◽  
Ann M. Gronowski
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Fetal Lung ◽  
Fetal Lung Maturity ◽  
Lung Maturity

The effect of freezing amniotic fluid on lamellar body count fetal lung maturity testing

2017 ◽  
Vol 137 (2) ◽  
pp. 203-204
Author(s):  
Sarah Carroll ◽  
Craig V. Towers ◽  
Lynlee Wolfe ◽  
Lisa Duncan ◽  
Beth Weitz ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Lamellar Body ◽  
Fetal Lung ◽  
Fetal Lung Maturity ◽  
Lung Maturity ◽  
Body Count

Prospective clinical evaluation of an improved fluorescence polarization assay for predicting fetal lung maturity.

1987 ◽  
Vol 33 (4) ◽  
pp. 554-558 ◽  
Author(s):  
J F Talt ◽  
C A Foerder ◽  
E R Ashwood ◽  
T J Benedetti
Keyword(s):  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Clinical Evaluation ◽  
Fluorescence Polarization ◽  
Distress Syndrome ◽  
Fetal Lung ◽  
Clinical Severity ◽  
Fetal Lung Maturity ◽  
Fluorescence Polarization Assay ◽  
Lung Maturity

Abstract We performed a prospective clinical evaluation of our newly developed fluorescence polarization procedure to predict fetal lung maturity (Clin Chem 1986;32:248-54). Net fluorescence polarization was measured at 34 degrees C after a 6.5-min incubation of amniotic fluid with fluorophore. For the 26 cases of neonatal respiratory distress syndrome encountered in 196 deliveries, the net polarization exceeded 0.287 for 22 (85%) of these, and exceeded 0.260 for all 26. The specificity of the polarization assay equaled or exceeded the specificity of the lecithin/sphingomyelin ratio for all sensitivities greater than 70%. Neither assay was a good predictor of the clinical severity of respiratory distress. For a separate group of 21 amniotic fluid specimens clinically contaminated with blood or meconium, the discriminatory power of the polarization assay was decreased, but six of seven respiratory-distress cases still had polarization values greater than 0.260. We conclude that this fluorescence polarization assay is a better overall predictor of fetal lung maturity than is the lecithin/sphingomyelin ratio, and that polarization values less than 0.260 are associated with little risk of respiratory distress.

Fetal lung maturity assessed by fluorescence polarization: evaluation of predictive value, correction for endogenous fluorescence, and comparison with L/S ratio.

1983 ◽  
Vol 29 (2) ◽  
pp. 346-349 ◽  
Author(s):  
K H Cox ◽  
J B Ross ◽  
A P Peterson ◽  
T J Benedetti
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Fetal Lung ◽  
Clinical Samples ◽  
High Risk Population ◽  
Clinical Tool ◽  
Fetal Lung Maturity ◽  
Endogenous Fluorescence ◽  
Lung Maturity

Abstract The steady-state polarization (or anisotropy) of the fluorescent dye 1,6-diphenyl-1,3-5-hexatriene in amniotic fluid samples and the lecithin/sphingomyelin ratio of the samples were correlated with development of respiratory distress syndrome in newborns. We found that clinical samples have a variable endogenous fluorescence that reduces the observed polarization (or anisotropy). This background is a major interference in the assessment of fetal lung maturity by the polarization method. Correction for this interference, by also measuring the blank fluorescence and anisotropy of the sample, provides a clinical tool with a lower coefficient of variation than that of the more time-consuming lecithin/sphingomyelin ratio. The clinical correlation for 17 cases of respiratory distress syndrome in a high-risk population (60 births; twins counted as a single birth) indicates that the two methods are equivalent for predicting immature fetal lung status.

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