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 f...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 × 10<sup>3</sup>/μL can be used safely to decide fetal lung maturity with sensitivity of 95.7% and specificity of 97.6%.展开更多
为研究羊水板层小体计数对双胎妊娠胎肺成熟的预测价值,选取196例28~38+6周分娩并排除严重妊娠并发症、合并症的双胎妊娠产妇为研究对象,于分娩时采集羊水用全血细胞仪检测板层小体数值(lamellar body count,LBC),随后追踪发生新生儿呼...为研究羊水板层小体计数对双胎妊娠胎肺成熟的预测价值,选取196例28~38+6周分娩并排除严重妊娠并发症、合并症的双胎妊娠产妇为研究对象,于分娩时采集羊水用全血细胞仪检测板层小体数值(lamellar body count,LBC),随后追踪发生新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)及新生儿短暂性呼吸困难症(transient tachypnea of newborn,TTN)的情况,记录LBC及NRDS、TTN等数据,分析并绘制ROC曲线,确立本研究羊水LBC预测双胎胎肺成熟的切割值。羊水LBC与双胎胎肺成熟度相关;选取35.5×109/L为切割值时,其AUC面积0.921,灵敏度87.1%,特异度87.8%,阳性预测值38.03%阴性预测值98.75%,将LBC联合孕龄共同预测,AUC面积0.955,以0.041为切割值,灵敏度0.968,特异度0.814,阳性预测值30.61%,阴性预测值99.66%。羊水LBC-对双胎妊娠胎肺成熟有较高的预测价值,当联合孕龄共同预测,预测效能较单一LBC值预测有明显提高。展开更多
文摘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 × 10<sup>3</sup>/μL can be used safely to decide fetal lung maturity with sensitivity of 95.7% and specificity of 97.6%.
文摘为研究羊水板层小体计数对双胎妊娠胎肺成熟的预测价值,选取196例28~38+6周分娩并排除严重妊娠并发症、合并症的双胎妊娠产妇为研究对象,于分娩时采集羊水用全血细胞仪检测板层小体数值(lamellar body count,LBC),随后追踪发生新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)及新生儿短暂性呼吸困难症(transient tachypnea of newborn,TTN)的情况,记录LBC及NRDS、TTN等数据,分析并绘制ROC曲线,确立本研究羊水LBC预测双胎胎肺成熟的切割值。羊水LBC与双胎胎肺成熟度相关;选取35.5×109/L为切割值时,其AUC面积0.921,灵敏度87.1%,特异度87.8%,阳性预测值38.03%阴性预测值98.75%,将LBC联合孕龄共同预测,AUC面积0.955,以0.041为切割值,灵敏度0.968,特异度0.814,阳性预测值30.61%,阴性预测值99.66%。羊水LBC-对双胎妊娠胎肺成熟有较高的预测价值,当联合孕龄共同预测,预测效能较单一LBC值预测有明显提高。
