Modified lamellar body phospholipid assay compared with L/S ratio and phosphatidylglycerol assay for assessment of fetal pulmonary status.

We used a modified lamellar body phospholipid (LB-PL) assay to evaluate the effect of sample processing and to evaluate the clinical efficacy of LB-PL determinations. Within-run and between-run CVs for the modified LB-PL assay respectively ranged from 2.9 to 6.7% and from 3.4 to 14.3%. Freezing and storage at -20 degrees C did not affect results for LB-PL (n = 12). Statistically significant amounts of lamellar bodies were lost on centrifugation, ranging from 20% at 150 X g to 54% at 1000 X g for 5 min. The LB-PL content, lecithin/sphingomyelin ratio, and phosphatidylglycerol content of 194 samples of amniotic fluid obtained within three days of delivery were compared for the assessment of fetal pulmonary maturity. Twenty-three neonates developed respiratory problems at or shortly after birth. With uncontaminated samples (n = 160), the LB-PL assay exhibited better specificity than the lecithin/sphingomyelin ratio (p less than 0.01, Chi square) or the phosphatidylglycerol assay (p less than 0.001, Chi square) for samples obtained after 36 weeks of gestation. Assay sensitivities did not differ significantly. Differences among assay predictive values were not significant.