Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2006, vol. 15, nr 2, March-April, p. 345–353

Publication type: review article

Language: Polish

Przydatność współczesnej diagnostyki laboratoryjnej w ocenie dojrzałości płuc płodu

The Usefulness of Contemporary Laboratory Medicine in Fetal Lung Maturity Assessment

Agnieszka Sapa1,

1 Katedra i Zakład Analityki Medycznej AM we Wrocławiu

Streszczenie

Przedwczesny poród może być obarczony ryzykiem wystąpienia u noworodka następstw klinicznych związanych z niedojrzałością układu oddechowego. Prawidłowe określenie dojrzałości płuc jest niezwykle cenną informacją dla klinicystów. Dynamiczny rozwój diagnostyki dojrzałości płuc płodu sprawił, że obecnie jest dostępnych wiele testów, pozwalających na ocenę stanu płodu jeszcze przed porodem. Nie wszystkie badania można jednak zalecić. Niniejsza praca ma na celu omówienie współczesnych metod diagnostycznych z uwzględnieniem ich przydatności klinicznej oraz czynników przedanalitycznych. Przedstawiono między innymi wyznaczanie stosunku lecytyna/sfingomielina, określanie poziomu fosfatydyloglicerolu, metody wykorzystujące fizyczne właściwości płynu owodniowego, w tym polaryzację fluorescencji oraz określanie liczby ciał lamelarnych. Pomimo wielu wad, wyznaczanie stosunku lecytyna/sfingomielina wciąż jest metodą referencyjną. Laboratoria zajmujące się diagnostyką prenatalną powinny rozważyć oferowanie szybkich i niedrogich testów, takich jak: określanie liczby ciał lamelarnych za pomocą analizatorów hematologicznych oraz wyznaczanie stosunku surfaktant/albumina komercyjnym testem FLM II firmy Abbott.

Abstract

A preterm delivery may bring a risk of complications to the infant because of the immaturity of the respiratory system. The correct prediction of lung maturity is a very precious information for a clinician. Dynamic development of the fetal lung maturity testing brought a lot of tests that allow to evaluate the statement of the fetus before a delivery. These tests do not have an equal value. The aim of the study is to present contemporary diagnostic methods, taking into consideration their clinical usefulness and preanalytical factors. Among others there are the lecithin/sphingomyelin ratio, phosphatidylglycerol, methods based on physical properties of the amniotic fluid including the fluorescense polarization and the lamellar body count. The L/S ratio, despite many disadvantages, is still a reference method. Laboratories that perform perinatal diagnostics should consider offering quick and cheap tests, such as the lamellar body count which is carried out by hematology blood analyzers or the surfactant/albumin ratio with a commercial FLM II assay (Abbott).

Słowa kluczowe

dojrzałość płuc płodu, zespół niewydolności oddechowej noworodków, płyn owodniowy

Key words

fetal lung maturity, respiratory distress syndrome, amniotic fluid

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