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LBC<br />

60450<br />

utilizing the platelet channel and used to estimate fetal lung maturity.<br />

Useful For: Predicting fetal lung maturity and assessing the risk of developing neonatal respiratory<br />

distress syndrome, when performed during 32 to 39 weeks gestation Useful in cases in which lamellar<br />

body count results are indeterminate<br />

Interpretation: Lamellar body count (LBC): Amniotic fluid LBC >50,000/mcL is predictive of fetal<br />

lung maturity. Amniotic fluid LBC or = 2.5<br />

and PG absent: indeterminate LS ratio < 2.5 and PG trace: indeterminate L/S ratio > or = 2.5 and PG<br />

trace: mature PG present: mature<br />

Reference Values:<br />

Immature: 50,000/mcL<br />

Cutoffs are based on consensus protocol (Neerhof M, Dohnal JC, Ashwood ER, et al: Lamellar body<br />

counts: a consensus on protocol. Obstet Gynecol 2001;97:318-320)<br />

Clinical References: 1. Fetal Lung Maturity. ACOG Practice bulletin. Obstet Gynecol September<br />

2008;112(3):717-726 2. Eby C, Lu J, Gronowski AM: Lamellar Body Counts Performed on Automated<br />

Hematology Analyzers to Assess Fetal Lung Maturity. Lab Med 2008;39(7):15 3. Haymond S, Luzzi V,<br />

Parvin C, Gronowski A: A Direct Comparison Between Lamellar Body Counts and Fluorescent<br />

Polarization Methods for Predicting Respiratory Distress Syndrome. Am J Clin Pathol 2006;126:894-899<br />

4. Szallasi A, Gronowski A, Eby C: Lamellar Body Count in Amniotic Fluid: A Comparative Study of<br />

Four Different Hematology Analyzers. Clin Chem 2003;49(6):994-997 5. Grenache DG, Gronowski AM:<br />

Fetal lung maturity. Clin Biochem 2006;39:1-10 6. Neerhof M, Dohnal JC, Ashwood ER, et al: Lamellar<br />

body counts: a consensus on protocol. Obstet Gynecol 2001;97:318-320<br />

Lamellar Body Count, Amniotic Fluid<br />

Clinical Information: Fetal lung maturity testing is used to determine the risk for developing<br />

respiratory distress syndrome (RDS) in infants born prematurely (32-39 weeks). The risk for developing<br />

RDS is inversely related to gestational age and is the most common cause of respiratory failure in<br />

neonates. RDS is associated with preterm birth due to insufficient production of pulmonary surfactant.<br />

Pulmonary surfactant is synthesized by type II pneumocytes. Surfactant consists of 90% phospholipids<br />

(primarily phosphatidylcholine and phosphatidylglycerol) and 10% proteins (surfactant proteins [SP]-A,<br />

SP-B, SP-C). Surfactant is packaged into lamellar bodies and is excreted into the alveolar space where it<br />

unravels and forms a monolayer on alveolar surfaces. Lamellar bodies can also pass into the amniotic<br />

cavity and, hence, are found in amniotic fluid. The surfactant functions to reduce the surface tension in the<br />

alveoli, preventing atelectasis. When surfactant is deficient, the small alveoli collapse and the large alveoli<br />

become overinflated and stiff, which has been associated with increased risk of developing respiratory<br />

distress. The status of fetal lung maturity is reflected in the concentration of surfactant in the form of<br />

phospholipids (see also FLP/8929 Fetal Lung Profile, Amniotic Fluid) and lamellar bodies present in<br />

amniotic fluid. Lamellar bodies are similar in size to platelets and can be quantified on a hematology<br />

analyzer utilizing the platelet channel and used to estimate fetal lung maturity. FLP/8929 Fetal Lung<br />

Profile, Amniotic Fluid and LBC/60450 Lamellar Body Count, Amniotic Fluid are individually orderable.<br />

A reflexive testing algorithm (LBCR/61179 Lamellar Body Count Reflex, Amniotic Fluid) is available to<br />

reflex indeterminate lamellar body count results for FLP/8929 Fetal Lung Profile, Amniotic Fluid<br />

(lecithin/sphingomyelin [L/S] ratio and phosphatidylglycerol [PG] testing).<br />

Useful For: Predicting fetal lung maturity and assessing the risk of developing neonatal respiratory<br />

distress syndrome, when performed during 32 to 39 weeks gestation<br />

Interpretation: Amniotic fluid lamellar body count (LBC) >50,000/mcL is predictive of fetal lung<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 1086

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