Comparison of vaginal and transabdominal collection of amniotic fluid for fetal lung maturity tests

Wijnberger, Lia D. E.; Kleine, M. de; Voorbij, H. A. M.; Arabin, Birgit; Engel, Henk; Bruinse, Hein W.; Visser, Gerard H.A.; Mol, Ben Willem J.

doi:10.3109/14767050903258704

Cited by 4 publications

(1 citation statement)

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“…LBC correlates with lung aeration evaluated by a semi-quantitative lung ultrasound score [11, 12]. LBC can be realized on amniotic fluid and is used as prenatal lung maturity test, as it has a good reliability to predict the RDS occurrence [13, 14], but is also doable postnatally (at the delivery or using gastric aspirates obtained before the first feeding) [15–17].…”

Section: Introductionmentioning

confidence: 99%

Estimation of early life endogenous surfactant pool and CPAP failure in preterm neonates with RDS

et al. 2019

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Background It is not known if the endogenous surfactant pool available early in life is associated with the RDS clinical course in preterm neonates treated with CPAP. We aim to clarify the clinical factors affecting surfactant pool in preterm neonates and study its association with CPAP failure. Methods Prospective, pragmatic, blind, cohort study. Gastric aspirates were obtained (within the first 6 h of life and before the first feeding) from 125 preterm neonates with RDS. Surfactant pool was measured by postnatal automated lamellar body count based on impedancemetry, without any pre-analytical treatment. A formal respiratory care protocol based on European guidelines was applied. Clinical data and perinatal risk factors influencing RDS severity or lamellar body count were real-time recorded. Investigators performing lamellar body count were blind to the clinical data and LBC was not used in clinical practice. Results Multivariate analysis showed gestational age to be the only factor significantly associated with lamellar body count (standardized β:0.233; p = 0.023). Lamellar body count was significantly higher in neonates with CPAP success (43.500 [23.750–93.750]bodies/μL), than in those failing CPAP (20.500 [12.250–49.750] bodies/μL; p = 0.0003).LBC had a moderate reliability to detect CPAP failure (AUC: 0.703 (0.615–0.781); p < 0.0001; best cut-off: ≤30,000 bodies/μL). Upon adjustment for possible confounders, neither lamellar body count, nor its interaction factor with gestational age resulted associated with CPAP failure. Conclusions Early postnatal lamellar body count on gastric aspirates in CPAP-treated preterm neonates with RDS is significantly influenced only by gestational age. Lamellar bodies are not associated with CPAP failure. Thus, the endogenous surfactant pool available early in life only has a moderate reliability to predict CPAP failure.

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