Amniotic lamellar body counts determined with the Sysmex^R XE-2100 analyzer to predict fetal lung maturity during diabetic and other complicated pregnancies

Abstract

Objective. The detection of amniotic lamellar bodies (LB) has been shown to be a rapid and simple way to assess fetal lung maturity (FLM). The maturity thresholds for LB vary due to different factors, one being the type of particle-count analyser used. Material and methods. The Sysmex^R XE-2100 hematological analyser was evaluated in determination of amniotic LB counts and compared with lecithin/sphingomyelin (L/S) and phosphatidylglycerol (PG) determination. We analysed 132 amniotic samples from a total of 109 mothers (71 diabetic) with 112 infants. Results. The correlation between the LB counts obtained with the Sysmex^R XE-2100 and our reference thin layer chromatography (TLC) phospholipid method was good. Samples with low L/S ratio (≤2.0) and no PG (i.e. premature fetal lung status), had low LB counts (n = 18, mean 8500/uL, range 1000–26000), whereas 51 samples with mature fetal lung status had high LB counts (mean 63600/uL, range 20,000–139,000). In all our four cases of respiratory distress syndrome the LB counts were low (range 1000 – 28000/uL). The reference values for FLM determination were established: ≤6000/uL for immature, values between 7000 and 35,000/uL for borderline results and >35,000/uL for mature. Conclusions. The amniotic LB count analysis with Sysmex^R XE-2100 has many advantages being a repeatable, inexpensive and quantitative method with a very short turn-around time. Consequently, our routine is to perform LB counts initially from all amniotic samples and only borderline LB results are analysed with TLC.

Key Words::

• Lamellar bodies
• fetal lung maturity
• diabetes

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.