Comparison between Amniotic Fluid Lamellar Body Count and Fetal Pulmonary Artery Doppler Indices in Predicting Fetal Lung Maturity in Cases of PPROM
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- Category: Vol. 90, June 2022
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Comparison between Amniotic Fluid Lamellar Body Count and Fetal Pulmonary Artery Doppler Indices in Predicting Fetal Lung Maturity in Cases of PPROM, HOSSAM ELDEIN HUSSEIN, ASEM A. ABDO MOUSSA and ISMAIL M. MOHAMED
Abstract
Background: Preterm premature rupture of membranes (PPROM) causes serious neonatal complications mainly respiratory distress syndrome (RDS) which affect large portion of pregnancies complicated by PPROM. Aim of Study: To compare between lamellar body count and fetal pulmonary artery Flow velocity wave forms for prediction of fetal lung maturity. Patients and Methods: This study was carried on 120 patients presented with pre-labor rupture of membranes at Al-Galaa Teaching Hospital, to compare between the roles of fetal pulmonary artery flow velocity waveforms and amniotic fluid lamellar bodies count for prediction of fetal lung maturity, in a prospective cohort study. Sonographic and amniotic fluid characteristics revealed mean amniotic fluid index (AFI) of 4.1cm with mean At/Et ratio (0.2). A mean level of lamellar body count 41683 was detected. Results: The cutoff value for LBC in predicting fetal lung maturity in our study was >!20,000/µL. Comparison between cases with RDS and cases without RDS regarding LBC level and fetal MPA Doppler indices revealed statistically significant differences on basis of LBC level (p-value 0.002), fetal MPA PI (p-value 0.003), RI (p-value 0.002) and At/Et ratio (p-value <0.001). It was noted that S/D ratio was of no signifi-cance between cases with RDS & those without RDS. Fetal MPA At/Et ratio was more sensitive and also more specific in prediction of lung maturity than lamellar body count which makes it a better choice than the invasive procedure entailing LBC measurement. Conclusion: Both main pulmonary artery (MPA) At/Et ratio and lamellar body count (LBC) be used in detecting fetal lung maturity and predicting neonatal respiratory distress but MPA AT/ET ratio are more sensitive, specific and less invasive.