Validity of Lamellar Body Count as a Fetal Lung Maturity Assessment in Twin Pregnancy

Department of Obstetrics and Gynecology, Nagoya University School of Medicine, Nagoya, Japan.
Twin Research and Human Genetics (Impact Factor: 2.3). 08/2012; 15(4):547-9. DOI: 10.1017/thg.2012.29
Source: PubMed


Fetal lung maturity assessment in twin pregnancy has been discussed, but is still controversial. The purpose of this study is to predict the occurrence of respiratory distress syndrome (RDS) using lamellar body count (LBC) and analyze the validity of LBC for fetal lung maturity assessment in twin pregnancy. Three-hundred two amniotic fluid samples were obtained at cesarean section from 29 to 38 weeks of gestation. Samples were analyzed immediately with no centrifugation and the number of lamellar bodies was counted using a platelet channel on the Sysmex SF-3000. There were 18 neonates (6.0%) suffering from RDS. An LBC cut-off value of 2.95×10⁴/μL resulted in 91.5% sensitivity and 83.3% specificity for predicting RDS. This cut-off value for predicting RDS was the same as that in singleton pregnancy. Moreover, the median LBC value in RDS cases was significantly lower than in non-RDS cases (1.50±1.1×10⁴/μL vs. 10.6±7.5×10⁴/μL; p<.001). This is the first report on the validity of LBC in twin pregnancy and also the largest study on fetal lung maturity assessment in twin pregnancy. An LBC value of >2.95×10⁴/μL means reassuring findings for RDS even in twin pregnancy. We believe the data in this study provide valuable, new information for the management of twin pregnancies.

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Available from: Tomomi Kotani, May 10, 2014
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    ABSTRACT: Twin pregnancies have a higher rate of preterm births, making precise prediction of neonatal respiratory disorders essential. We herein examined the amniotic lamellar body count (LBC) and found it to be an accurate predictor of respiratory disorders in twin pregnancies. Five hundred fourteen amniotic fluid samples, comprising 132 dichorionic twins (DCT) and 125 monochorionic twins (MCT) gestations, were obtained at Cesarean section performed at 29 to 38 gestational weeks. Samples were analyzed immediately without centrifugation. There were 26 neonates (5.1%) with respiratory distress syndrome (RDS) and 43 (8.4%) with transient tachypnea of the newborn (TTN). The LBC in neonates with TTN (5.12×10(4)/μl) was between the counts in RDS (1.26×10(4)/μL) and controls (10.6×10(4)/μl), which differed significantly. Twin concordance rates were significantly higher for TTN in MCT gestations than DCT gestations (p=0.003) and delta LBC value was significantly smaller in MCT (3.15±0.4×10(4)/μL) than DCT (5.17±0.5×10(4)/μL) gestations (p=0.003). The amniotic LBC is useful for predicting respiratory disorders, including RDS and TTN, in twin pregnancies. The data in this study may indicate a genetic predisposition to TTN among MCT. Copyright © 2014. Published by Elsevier B.V.
    Clinica Chimica Acta 12/2014; 441. DOI:10.1016/j.cca.2014.12.019 · 2.82 Impact Factor