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: 1.64). 08/2012; 15(4):547-9. DOI: 10.1017/thg.2012.29
Source: PubMed

ABSTRACT 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.

1 Bookmark
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to determine gestational age-specific incidence and risk factors of respiratory distress syndrome (RDS) in twins compared with singletons. An analysis of 850,406 singleton and 23,278 twin infants born alive in Finland between 1987 and 2000 was performed. A number of antenatal and perinatal/intranatal factors were evaluated. At less than 28 weeks of gestation, the incidence of RDS was higher in both first- and second-born twins compared with singletons. At more advanced gestation, first-born twins had a significantly lower incidence of RDS compared with the others. There was no difference in the concordance of RDS between same-sex and opposite-sex twin pairs. Vaginal delivery, female sex, being born first, and being the lighter of the twins protected from RDS. After taking into account gestation, twins are not at higher risk of RDS compared with singletons except at very early gestation. Environmental factors predominate over genetic ones in the predisposition to RDS in twins.
    American Journal of Obstetrics and Gynecology 08/2004; 191(1):271-6. · 3.88 Impact Factor

Full-text (2 Sources)

Available from
May 29, 2014