TITLE:
Lamellar Bodies Count (LBC) as a Predictor of Fetal Lung Maturity in Preterm Premature Rupture of Membranes Compared to Neonatal Assessment
AUTHORS:
Malames Mahmoud Faisal, Noha Hamed Rabei, Hoda Ezz El-Arab Abd El-Wahab, Abeer Hosny El-Zakkary
KEYWORDS:
Fetal Lung Maturity, Lamellar Bodies Count, Preterm Premature Rupture of Membranes, Respiratory Distress Syndrome
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.6,
June
21,
2023
ABSTRACT: Background: Respiratory distress syndrome (RDS) is a major cause of neonatal morbidity and mortality, affecting approximately 1%
of all live births and 10% of all
preterm infants. Lamellar bodies represent a storage form of pulmonary surfactant within Type II pneumocytes,
secretion of which increases with advancing gestational age, thus
enabling prediction of the degree of FLM.
Preterm premature rupture of membranes (PPROM) complicates approximately
1/3 of all preterm births. Birth within 1 week is the most likely outcome for any patient with PPROM in the absence
of adjunctive treatments. Respiratory distress has been reported to be
the most common complication of preterm birth. Sepsis, intraventricular
haemorrhage, and necrotizing enterocolitis also are associated with
prematurity, but these are less common near to term. Objective: To
assess the efficacy of the amniotic fluid lamellar body counting from a vaginal
pool in predicting fetal lung maturity in women with preterm premature rupture of membranes. Methods: This study was
conducted at Ain Shams University Maternity Hospital in the emergency ward from January 2019 to September 2019. It included 106 women with singleton pregnancies, gestational
age from 28 - 36 weeks with preterm premature rupture of membranes. This study is
designed to assess the efficacy of the amniotic fluid lamellar body counting
(LBC) from a vaginal pool in predicting fetal lung
maturity in women with preterm premature rupture of membranes. Results: The current study revealed a highly significant increase in the lamellar body count in cases giving birth to neonates
without RDS compared to that cases giving birth to neonates with RDS.
Also, no statistically significant difference between LBC and age, parity and
number of previous miscarriages in the mother was found.
Gestational age at delivery was significantly lower among cases with
respiratory distress. Steroid administration was significantly less frequent among cases with respiratory
distress. However, lamellar bodies had
high diagnostic performance in the prediction of respiratory distress. Conclusion: Lamellar
body count (LBC) is an effective, safe, easy, and cost-effective method to assess fetal lung maturity
(FLM). It does not need a highly equipped laboratory or specially trained
personnel, it just needs the conventional blood count analyzer. Measurement of
LBC is now replacing the conventional Lecithin/Sphyngomyelin L/S ratio. LBC
cut-off value of ≤42.5 × 103/μL can be used safely to decide fetal
lung maturity with sensitivity of 95.7% and
specificity of 97.6%.