الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 140 |  |  |
| | | from | 140 | | |
Abstract
It would be convenient to predict fetal lung immaturity before an elective birth noninvasively to allow therapeutic protection against possible respiratory distress syndrome (RDS) in the neonate, or in some cases, to estimate the effect of adrenal steroid treatment of a preterm fetus by repeated tests that can be freely performed by noninvasive techniques. Prenatal diagnosis permits delivery by planned caesarean section sufficiently early to avoid the possible complications.Neonatal respiratory distress syndrome, or RDS, is a common cause of respiratory distress in a newborn, presenting within hours after birth, most often immediately after delivery. RDS primarily affects preterm neonates, and infrequently, term infants. The incidence of RDS is inversely proportional to the gestational age of the infant, with more severe disease in the smaller and more premature neonates. RDS can cause hypoxemia through alveolar hyperventilation, diffusion abnormality, ventilation-perfusion mismatch, intrapulmonary shunting, or a combination of these mechanisms. This hypoxemia and tissue hypoperfusion ultimately lead to increased anaerobic metabolism at a cellular level with resultant lactic academia. The introduction of ultrasound to obstetrics and gynecology has made tremendous impact to patient care as it allowed imaging of the fetus and placenta in obstetrics and maternal internal organs in gynecology with such clarity to allow advanced diagnosis and also to guide various lifesaving interventions Noninvasive direct assessment of fetal lung maturity was studied by the ultrasonic fetal lung frequency component, B-mode image texture and special mean gray level, where the ultrasonic methods should rely on a special computer system or the mean gray level was so unstable to the device gain and the depth of the subjects that every measurement needed test piece calibration. Ultrasonography has contributed by the use of chest circumference and area or by comparison with other fetal measurements. The aim of the study was to evaluate the validity of measuring fetal thalamic echogenicity by ultrasound as a marker of fetal lung maturity. This was a prospective observational study that was being carried out on 80 pregnant patients. They were recruited from Obstetrics and Gynaecology clinics at Tanta University Hospitals during the period of research from March 2021 till the end of the study. The main findings of the study revealed that: ● The age ranges from 22 to 40 years with median 34 years. The mean BMI was 23.1± 1.9 among the participants. The BMI was ranging from 20 to 26 with median 23. There were 25% primigravida among the participants. There was 20% nullipara among the participants. There were 32.5% had previous history of abortion among the participants. There were 33.8% had previous history of caesarean among the participants. ● As regard vital signs of participants, the mean of systolic blood pressure was 119.8 ± 12.3 among the participants. The mean of diastolic blood pressure was 71.1 ±6.0 among the participants. The mean of pulse 85.2 ±9.4 among the participants. The mean of temperature was 37.6 ± 0.4 among the participants. ● The mean gestational age was 34.6 ± 0.4 weeks among the participants. The mean BPD was 77.6 ± 12.8 among the participants. The mean femur length was 62.5 ± 6.8 among the participants. The mean abdominal circumference was 294.6 ± 20.6 among the participants. The mean head circumference was 270 ± 2.1 among the participants. ● There were 88.8% had amniotic fluid vernix and 11.2% had no amniotic fluid vernix among the participants. The mean AFI was 130.7 ± 7.3 among the participants. There were 13.8% had turbid amniotic fluid among the participants. There were 15% grade I placental calcification, 28.7% were grade II and 56.3% grade III among the participants ● There were 87.5% had echogenic and 12.5% had Echolucent among the participants. There were 60% had cephalic presentation, 33.8% had breech presentation and 6.2% had other presentations. ● The mean gestational age was 36.6 ± 0.5 weeks among the participants. The mean BPD was 92.3 ± 4.9 among the participants. The mean femur length was 66.1 ± 6.9 among the participants. The mean abdominal circumference was 297.3 ± 48.2 among the participants. The mean head circumference was 290 ± 7.3 among the participants. ● There were 95% had amniotic fluid vernix and 5% had no amniotic fluid vernix among the participants. The mean AFI was 135.7 ± 24.8 among the participants. There were 16.3% had turbid amniotic fluid among the participants. There were 8.7% grade I placental calcification, 33.8% were grade II and 57.5% grade III among the participants. There were 93.8% had echogenic and 6.2% had Echolucent among the participants ● There were 33.8% admitted to NICU among them 8.7% for less than 24 hours, 16.3% admitted for 24 to 48 hours, and 8.8% for more than 48 hours. There were 18.8% had RDS. The neonatal mortality was among 1.3% of the participants. ● The mean 1-min APGAR score was 6.0± 1.5 and there were 77.5% had 1-min APGAR less than 7. The mean 5-min APGAR score was 6.3± 1.6 and there were 73.8% had 5-min APGAR less than 7. The mean fetal weight was 3164.5± 605.1 grams. There were 55% males and 45% females among the participants. ● There was statistically significant difference between RDS group and those without RDS regarding thalamic echogenicity, 1 and 5- min APGAR score, NICU admission and neonatal mortality. ● The specificity and the sensitivity values are higher for the thalamic density. The AUC was 79.2%, Sensitivity was 60% while the specificity was 98.5%. Based on our findings, we recommend for further studies on larger sample size and on large geographical scale to emphasize our conclusion.