الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Preterm labor is an obstetrics emergency and a threat to population health. 75% of infant mortality is related to preterm labor .
Respiratory distress syndrome (is a result of surfactant deficiency), RDS is the most common cause of respiratory distress in preterm infants because lung immaturity is associated with inadequate production of pulmonary surfactant.
Cesarean section in the absence of labor (in mature fetuses) is likely a significant risk factor for newborn TTN rather than RDS. Although elective cesarean delivery before fetal maturity may result in iatrogenic RDS, the absence of labor is associated with an increase in TTN.
Antenatal steroids given to pregnant women expecting preterm delivery. They have been shown to reduce the morbidity and mortality of hyaline membrane disease.
Doppler flow studies of maternal and fetal vessels has provided a tool where the physiology of the maternal-fetal unit can be assessed. The most commonly assessed Doppler flow studies of the fetus are the umbilical artery and middle cerebral artery (MCA). Doppler flow studies of the MCA are used in the assessment of the fetus at risk for anemia and growth-restricted fetus.
The current study was a prospective cross sectional study the study was conducted in Menouf general hospital, Al Menoufia, Egypt, from November 2017 to November 2018. Eligible participants were pregnant women who were divided into two groups: The 1stgroup were between 28 weeks and 34 weeks of gestation at risk of preterm labor .The 2nd group were those who would undergo elective cesarean section before completing the 39th week of gestation.Patients at risk of preterm labor to be included were those with preterm uterine contractions, patientswith history of previous preterm labor. While patients who were with twin pregnancy, were actively in labor, patients presented with premature rupture of membranes, intrauterine growth restriction (IUGR),women with fetuses with suspected structural abnormalities and women who had any contraindication of corticosteroids administration .
Study intervention:
Eligible participants were evaluated through full history taking and detailed anatomical scan by skilled sonographer to confirm their gestational age and exclude any structural anomalies .Each woman received the recommended course of corticosteroids consists of 4 doses dexamethasone 6mg for 48 hrs Doppler studies were performed just before dexamethasone administration and repeated 24 h after completion of the dexamethasone dose using a Logic P5 machine (GE,Korea) with 3.75 MHz curvilinear transabdominal probe. Blood flow velocity waveforms were obtained from the umbilical artery, fetal middle cerebral artery (MCA).Spectral pulsed wave Doppler analysis was done after that; RI and PI were calculated for each vessel..
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Summary
Statistical analysis :
Collected data were reviewed and analyzed using the Statistic Package for Social Science Version 18 (SPSS 18.0) for windows. Qualitative data were expressed as frequency and percentage. Chi-square (X2) test was used to examine the relation between qualitative variables. Quantitative data were presented in terms of mean and standard deviation, and 2 inde-2E. Pendent samplest-tests were used to compare them. The level of significance was taken at p-value of 0.05.
Our data reveal a significant decrease in MCA PI After 24h of maternal last dexamethasone dose in fetuses whose gestational age was between 28 to 34 weeks of gestation. However, there was no effect on Doppler flow of neither umbilical nor middle cerebral arteries in fetuses whose gestational age was just before 39 weeks of gestation. But there were beneficial effect of dexamethasone on fetal respiratory functions on fetuses of both groups.