INVESTIGATION OF THE SUPERIORITY OF TDxFML AND LAMELLAR BODY COUNTS IN THE EVALUATION OF FETAL LUNG MATURATION

Abstract

Objective: To evaluate the superiority of the most performed tests; lamellar body counts and TDxFLM test compared to each other to estimate the maturation of fetal lungs and also to evaluate the reasons for the unclear cut-off values of lamellar body counts. Material and Method: Amnion fluids that were taken into 2 separate tubes from 56 patients within a year were evaluated with both of the tests. Newborns were evaluated and monitored for respiratory distress syndrome of newborns by a neonatologist who was blinded to the results of the amnion fluids. Clinical findings such as grunting, tachypnea, retractions and cyanosis beginning within 6-8 hours after birth, oxygen need over 24 hours, arterial blood gas analyses with partial oxygen pressure under 50 mmHg and presence of chest x-ray findings that are compatible with the situation were accepted as the respiratory distress of newborns. Results: Respiratory distress was not seen in 44 of the 56 newborns while it was seen in 12 (21.4%) of them. In 30 patients whose lamellar body counts were > 55000/mm(3) without centrifuge, RDS was not seen. In the patients whose lamellar body counts were < 40000/mm(3) the prevalence of RDS was 71.4. In the patients whose lamellar body counts were at interim values; secondary evaluation with TDx FLM can be performed. If the TDx FLM values exceeded > 41, all cases can be detected. Conclusion: Count of lamellar bodies is adiagnostic tool which is fast, practical, easily accessible and cost-effective; also there is no doubt on the benefits of the tool. It seems that the different cut-off values have reasonable causes. Thus, we suggest that every clinic should have its own cut-off values. In the presence of interim results, additional evaluation with TDxFLM was found to increase the sensitivity and specificity.