الفهرس 
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Abstract
Macrophage colony stimulating factor (M-CSF) is essential for the survival, growth, and development of the monocyte/ macrophage cell lineage. Experiments suggest that M-CSF has a major regulatory role in the development and maintenance of the mononuclear phagocytes in liver, spleen, and kidney. Most circulating M-CSF is cleared by binding to its receptor on the macrophages of the liver and spleen, with subsequent endocytosis of the receptor- ligand complex and intracellular degradation.
Cord blood M-CSF levels in neonates may be increased in response, not only to infection but also to stressed states such as mal-adaptation to extra uterine environment, fetal distress, neonatal asphyxia, state of nutrition, maternal infection, hypertention, and mode of delivery. This elevated level of M-CSF in cord blood persists in the neonatal peripheral blood for several days.
The aim of this work is to investigate M-CSF level, in cord blood of neonates with prenatal risk factors and comparing it with its level in normal healthy and septic neonates. Also, it is a trial to answer the question; Is M-CSF will be affected by perinatal risk factors or, infection or, both?
This work is carried out on 40 neonates (21 males and 19 Females) who where selected from Benha University hospitals between April and august 2003.
Our cases were classified into the following groups:
Group 1: 20 Full term neonates with normal vaginal delivery, normal birth weight, without any maternal or neonatal risk factors or sepsis, as a control group.
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Perinatal Complications and Markers of Infection (M-CSP)
Group II: 20 neonates with perinatal risk factors as prematutity, cesarean section, PROM, cardiac disease, obstetric complication as prolonged pregnancy, uterine/cervical abnormalities, PIH, IUGR, birth trauma, metabolic disorder and congenital infection. Five of them developed
sepsis.
Cord blood samples were obtained by needle puncture from the umbilical cord immediately following the delivery. M-CSF tested on all neonates to be included in the study to assess M-CSF level in the studied
groups.
Cases that developed sepsis have been investigated by complete blood picture, C-reactive protein and blood culture.
We found that:
M-CSF level is not affected by sex, birth weight, and-APGAR score in cases with perinatal risk factors, but affected by gestational age only. M-CSF level is higher in cord blood of normal neonates than the peripheral blood levels in adults.
M-CSF level is elevated because of perinatal complications including -PROM, CS, prematurity and chorioamniontis, but is not significantly different between each complication type and it is more elevated in neonatal sepsis, and not significantly higher between neonates who developed sepsis and neonates with perinatal complications.
So we conclude that: M-CSF is not a superior diagnostic tool in neonatal infections associated with insults in the perinatal period.