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دراسة علاقة طول عنق الرحم المقاس بالسونار الداخلي مزامنة مع كمية السائل الامنيوسي في توقع وقت حدوث الولادة المبكرة خلال سبعة ايام من تمزق غشاء السائل الامنيوسي المبكر == Transvaginal Cervical Length & Amniotic Fluid Index : Can They Predict Delivery Latency Following Preterm Premature Rupture Of Membrane

اسم المؤلف: وسن غائب حسون غائب

اسم المشرف: امال منير مبارك

الموضوع العام: الطب

السنة: 2016

الموضوع الدقيق: النسائية والتوليد

الدرجة: دبلوم عالي

الجامعة: جامعة الكوفة - كلية الطب - قسم النسائية والتوليد

اللغة: الانكليزية

مكان الجامعة: النجف

الكلمات الدلالية:

علاقه طول عنق الرحم المقاس بالسونار الداخلي مزامنة مع كمية السائل الامنيوسي في توقع حدوث الولادة المبكرة خلال سبعة ايام من تمزق غشاء السائل الامنيوسي المبكر

الصفحات الاولى: 📎 19T1190 - p.pdf

المستخلص: توقع حدوث الولادة عند الحوامل المصابات بتمزق غشاء السائل الامنيوسي المبكريساعد الحامل على تهيئه نفسها لدخول المستشفى لاجراء اللازم لها واعطاءالجرعةالمنشطةلرئة الطفل وادخاله الى وحده العناية المركزة لحديثي الولادة.هدف الدراسة : تهدف الدراسة الى قياس طول عن | Patients with PPROM are often hospitalized for a prolonged period of time and deliver premature infants who frequently require neonatal intensive care. These women and their infants contribute significantly to obstetric &neonatal health care costs. The prediction of delivery latency could help direct the need for specific interventions such as hospitalization, intensive monitoring, timing of antenatal steroids.Objective : To determine whether transvaginal CL, AFI,or a combination of both can predict delivery latency within 7 days in women presenting with PPROM.Methods and Study Design : This was a prospective observational study of TVCL measurements in 80 singleton pregnancies with PPROM between 24 - 34 weeks. Transvaginal ultrasonography was performed with TOSHIBA SSA - 340A(Tokyo - Japan) apparatus 7.5MHz transvaginal probe, to measure the CL&AFI. Delivery latency was defined as the period from the initial TVCL after PPROM to delivery of the baby with our primary outcome being delivery within 7 days of TVCL. The independent predictability of significant characteristics for delivery within 7 days was determined using multiple logistic regression.Sensitivity, specificity, and predictive values were used to determin, whether the presence of a short TVCL, AFI or a combination of both affected the risk of delivery within 7 days.Result : Our study in women with PPROM show the validity of CL in predicting labor when the cut off value2cm the sensitivity=52.6%, specificity=69%, PPV=60.6%, NPV =61.7% and Accuracy=61.25%.The validity of AFI when the cut off value 5cm the sensitivity=71.1%, specificity=50%, PPV=56.3%, NPV=65.6% and Accuracy=60%.With combination of CL&AFI in predicting time of labor after PPROM the sensitivity=50%, specificity=92.8%, PPV=86.4%, NPV=67.2% and Accuracy 72.5%.In women with PPROM the rate of gestational age ? 30 weeks that labored within 7 days 44.7% and those labored more than 7 days 55.3%.Also the rate of gestational age >30 weeks that delivered within and after 7 days are 50%.According to the parity we found the mean value of those delivered within 7 days are 1.24 and those after 7 days are 1.28.Conclusion : Our study shows there is increase in positive predictive value when combination of AFI and CL in prediction of time of labour so women with AFI?5 and CL?2 had 86.4% risk of delivery within 7 days after PPROM. Also the study found there was no significant association between gestational age, or parity with the prediction time of labor.