الفهرس 
NORMAL DEVELOPMENT AND MATURATIONOnly 14 pages are availabe for public view
 |  | from | 124 |  |  |
| | | from | 124 | | |
Abstract
Amniocentesis with determination of the phospholipid profile (L / S
ratio and PG levels) remains the most useful and universally acceptable
estimate of fetal lung maturity. Amniocentesis, however is an invasive
procedure with a small but significant fetal and maternal morbidity rate of
up to 15 % in the third trimester of pregnancy. (Mahony et al, 1986).
In the present study, a non – invasive method for assessment of
fetal lung maturity via sonographic characterization of changes of fetal
lung that lead to maturity and placental tissue and amniotic fluid feckers.
These sonographic parameters were studied in normal pregnancies to
assess their value in predicting fetal lung maturity in normal pregnancies.
78
The study was conducted on 80 pregnant females at gestational age
ranged from 28 w to 41 w who were selected from attendants of Benha
University Hospital.
Gestational age determination was based upon unequivocal
knowledge of the date of the last menstrual period together with
regularity of cycles in the months preceding pregnancy. Gestational age
was further confirmed by obtaining a composite sonographic age
estimate by BPD and femur length (Hadlock, 1990) which was within 1
w of menstrual age in 95 % of cases.
In every case, ultrasonography was used to examine and grade the
placenta according to the criteria developed by Grannum et al (1979)
and estimation of lung / liver ratio.
In the present study, a grade III placenta was used as
asonographic parameter to predict fetal lung maturity by correlating this
parameter with the echogenicity of lung / liver ratio as an indicator of
accuracy.
In the whole population studied, a grade III placenta predicted a
mature phospholipid profile (L / S ratio > 2 and PG > 2 %) in 81 % of
79
cases. Thus the false positive rate was 19 %. These results are in
agreement with those of Quinlan et al (1982), Harman et al (1982) and
Clair et al (1983).
On the other hand, Grannum et al (1979) and Petrucha et al
(1982) reported that grade III placenta was associated with fetal lung
maturity (as assessed by the L / S ratio and/or the PG levels) in 100% of
the cases.
All cases were delivered within 24 hours after ultrasonography, 67
cases had RDS (G1) while 13 cases had RDS (G2).
Mean gestational age, BPD and femur length were significantly
lower in (G1) (P < 0.001) than (G2).
Grade III placenta showed no RDS amniotic fluid was turbid in 78 %
in G1 compared to 55 % in G2 (P < 0.000196).
Lung / liver ratio showed the following:
All cases of hypoechoic had RDS.
Cases of isoechoic 60% had no RDS accuracy 60 %.
Hyperechoic 87.5 % had no RDS.
81
Hyperechoic and G III placenta 98 % cases had no RDS.