Amniotic fluid lamellar body counts for the determination of fetal lung maturity: an update.
OBJECTIVE
To reassess the cut-off value for lamellar body counts (LBs) for fetal lung maturity (FLM) over a 10-year study period.


METHODS
178 pregnancies were selected under strict inclusion criteria and delivered within 48 h from amniocentesis. FLM was determined by amniotic fluid LBs in centrifuged samples (300 x g for 10 min) in a commercially available Coulter Counter. Cases beyond 37 weeks were excluded.


RESULTS
Mean gestational age was 33.5+/-3.0 weeks at amniocentesis and 33.7+/-3.0 weeks at birth. After reassessing the best compromise between sensitivity and specificity for all cases using the receiver operating characteristic (ROC) procedure, an FLM cut-off value of < or = 22,000/microL was obtained. Diagnostic accuracy (and confidence interval, CI) was: sensitivity, 73% (60.0-83.6%); specificity, 81.7% (CI 73.6-88.1%); positive predictive value, 66.2%; and negative predictive value, 86.0%.


CONCLUSIONS
No significant change in FLM cut-off for LBs was found when comparing the value from this study and the results of our earlier report presented in 1996 (< or = 22,000 vs. < or = 20,000/microL), although the new value may be more accurate, since it is based on neonatal outcome with the exclusion of cases in which the diagnosis of FLM is seldom warranted, i.e., > 37 weeks' gestational age.
Piazze
Juan J
JJ
Institute of Gynecology, Perinatology and Child Health, University La Sapienza, Rome, Italy.
Maranghi
Luca
L
Cerekja
Albana
A
Meloni
Paolo
P
Gioia
Stefano
S
Fumian
Luisa
L
Cosmi
Ermelando V
EV
Anceschi
Maurizio M
MM
D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry*; D005260:Female; D005325:Fetal Organ Maturity / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000196:embryology*; D010743:Phospholipids / Q000032:analysis; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000517:prevention & control
D010743:Phospholipids