الفهرس 
FETAL MEMBRANES AND PRETERM PREMATURE RUPTURE OF MEMBRANESOnly 14 pages are availabe for public view
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Abstract
Background: Respiratory distress syndrome (RDS) is a major cause of neo- natal morbidity and mortality, affecting approximately 1% of all live births and 10% of all preterm infants. Lamellar bodies represent a storage form of pulmonary surfactant within Type II pneumocytes, secretion of which in- creases with advancing gestational age, thus enabling prediction of the degree of FLM. Preterm premature rupture of membranes (PPROM) complicates approximately 1/3 of all preterm births. Birth within 1 week is the most likely outcome for any patient with PPROM in the absence of adjunctive treatments. Respiratory distress has been reported to be the most common complication of preterm birth. Sepsis, intraventricular haemorrhage, and necrotizing ente- rocolitis also are associated with prematurity, but these are less common near to term. Objective: To assess the efficacy of the amniotic fluid lamellar body counting from a vaginal pool in predicting fetal lung maturity in women with preterm premature rupture of membranes. Methods: This study was con- ducted at Ain Shams University Maternity Hospital in the emergency ward from January 2019 to September 2019. It included 106 women with singleton pregnancies, gestational age from 28 - 36 weeks with preterm premature rup- ture of membranes. This study is designed to assess the efficacy of the amni- otic fluid lamellar body counting (LBC) from a vaginal pool in predicting fet- al lung maturity in women with preterm premature rupture of membranes. Results: The current study revealed a highly significant increase in the lamel- lar body count in cases giving birth to neonates without RDS compared to that cases giving birth to neonates with RDS. Also, no statistically significant difference between LBC and age, parity and number of previous miscarriages in the mother was found. Gestational age at delivery was significantly lower among cases with respiratory distress. Steroid administration was significant- ly less frequent among cases with respiratory distress. However, lamellar bodies had high diagnostic performance in the prediction of respiratory distress. Con- clusion: Lamellar body count (LBC) is an effective, safe, easy, and cost-effective method to assess fetal lung maturity (FLM). It does not need a highly equipped laboratory or specially trained personnel, it just needs the conventional blood count analyzer. Measurement of LBC is now replacing the conventional Le- cithin/Sphyngomyelin L/S ratio. LBC cut-off value of ≤42.5 × 103/µL can be used safely to decide fetal lung maturity with sensitivity of 95.7% and speci- ficity of 97.6%.