[Evaluation of fetal lung maturity by lamellar bodies counting in amniotic fluid]. 2010

Beatriz Maykot Kuerten Gil, and Eduardo de Souza, and Carlos Alberto Justo da Silva, and Cláudia Pinto Figueiredo
Departamento de Tocoginecologia e médica do Serviço de Ginecologia e Obstetrícia do Hospital Universitário da Universidade Federal de Santa Catarina - UFSC - Florianópolis, SC, Brasil. beakuerten_@hotmail.com

OBJECTIVE To compare the lamellar body number density (LBND) count in amniotic fluid using the fluorescent polarization (FP) test as a diagnostic parameter for the assessment of fetal pulmonary maturity. METHODS This was an analytical, controlled cross-sectional study conducted on 60 pregnant women from March 2002 to December 2007. Amniotic fluid specimens were obtained by amniocentesis or at the time of caesarean section, and submitted to the LBND and FP tests (TDxFLM, Abbott Laboratories), the latter considered to be a reference test, and compared in terms of the presence or absence of respiratory distress syndrome (RDS). Cut-off values for maturity were established at 30,000 lamellar bodies/microL for the LBND test and 55 mg/g albumin for the FP test. Maternal and perinatal characteristics and neonatal evolution were evaluated, and the performance of the diagnostic tests regarding fetal pulmonary maturity was determined. In the statistical analysis, descriptive measures were used and the sensitivity, specificity and positive and predictive values of the tests were determined with the level of significance set at p<0.05. RESULTS Maternal age ranged from 15 to 34 years (mean: 26.6 years) and gestational age ranged from 24.3 to 41.6 weeks (mean: 35.1 weeks). RDS was diagnosed in 35.1% of neonates. Perinatal characteristics such as weight, Apgar score, and RDS incidence were compared to the results of the LBND and FP tests and a significant correspondence (p<0.05) was observed between the groups of neonates clinically classified as mature and immature in both tests. The tests were concordant in 68.3% of the cases. Comparison of the PF and LBND tests revealed 100% specificity for both and a higher specificity for the LBND test (73.1% as opposed to 51.9% for the PF test). The gold standard for the determination of fetal maturity is the occurrence of RDS. The positive predictive value of the LBND test was higher (36.4%) than that of the FP test (24.2%) (p<0.05) and the negative predictive value was 100% for both tests. CONCLUSIONS The present study demonstrated that the LBND test has 100% sensitivity and higher specificity than the reference test (FP). In addition, the LBND test is considered to be rapid, accessible, inexpensive and feasible for the Brazilian reality, and it can be used as a reliable test for the prediction of fetal pulmonary maturity.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D003944 Diagnostic Techniques, Obstetrical and Gynecological Methods and procedures for the diagnosis of conditions related to pregnancy, labor, and the puerperium and of diseases of the female genitalia. It includes also demonstration of genital and pregnancy physiology. Diagnostic Technic, Obstetric and Gynecologic,Diagnostic Technic, Obstetrical and Gynecological,Diagnostic Technics, Obstetric and Gynecologic,Diagnostic Technics, Obstetrical and Gynecological,Diagnostic Technique, Obstetric and Gynecologic,Diagnostic Technique, Obstetrical and Gynecological,Diagnostic Techniques, Obstetric and Gynecologic,Obstetric and Gynecologic Diagnostic Technic,Obstetric and Gynecologic Diagnostic Technics,Obstetric and Gynecologic Diagnostic Technique,Obstetric and Gynecologic Diagnostic Techniques,Obstetrical and Gynecological Diagnostic Technic,Obstetrical and Gynecological Diagnostic Technics,Obstetrical and Gynecological Diagnostic Technique,Obstetrical and Gynecological Diagnostic Techniques,Technic, Obstetric and Gynecologic Diagnostic,Technic, Obstetrical and Gynecological Diagnostic,Technics, Obstetric and Gynecologic Diagnostic,Technics, Obstetrical and Gynecological Diagnostic,Technique, Obstetric and Gynecologic Diagnostic,Technique, Obstetrical and Gynecological Diagnostic,Techniques, Obstetric and Gynecologic Diagnostic,Techniques, Obstetrical and Gynecological Diagnostic
D005325 Fetal Organ Maturity Functional competence of specific organs or body systems of the FETUS in utero. Fetal Maturity, Functional,Functional Fetal Maturity,Maturity, Fetal Organ,Maturity, Functional Fetal,Organ Maturity, Fetal
D005454 Fluorescence Polarization Measurement of the polarization of fluorescent light from solutions or microscopic specimens. It is used to provide information concerning molecular size, shape, and conformation, molecular anisotropy, electronic energy transfer, molecular interaction, including dye and coenzyme binding, and the antigen-antibody reaction. Anisotropy, Fluorescence,Fluorescence Anisotropy,Polarization, Fluorescence,Anisotropies, Fluorescence,Fluorescence Anisotropies,Fluorescence Polarizations,Polarizations, Fluorescence
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000653 Amniotic Fluid A clear, yellowish liquid that envelopes the FETUS inside the sac of AMNION. In the first trimester, it is likely a transudate of maternal or fetal plasma. In the second trimester, amniotic fluid derives primarily from fetal lung and kidney. Cells or substances in this fluid can be removed for prenatal diagnostic tests (AMNIOCENTESIS). Amniotic Fluid Index,Amniotic Fluid Indices,Amniotic Fluids,Fluid Index, Amniotic,Fluid Indices, Amniotic,Fluid, Amniotic,Fluids, Amniotic,Index, Amniotic Fluid,Indices, Amniotic Fluid
D015388 Organelles Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the MITOCHONDRIA; the GOLGI APPARATUS; ENDOPLASMIC RETICULUM; LYSOSOMES; PLASTIDS; and VACUOLES. Organelle

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