Fetal-Lung-Maturity

Fetal-Lung-Maturity - Assessment of Fetal Lung Maturity Dr....

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Ashraf F I Nabhan 1 Assessment of Fetal Lung Maturity Dr. Ashraf Fawzy Nabhan Ain Shams University, Cairo, Egypt
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Ashraf F I Nabhan 2 Vision Statement An obstetric practice where the unnecessary tragedy of iatrogenic prematurity no longer exists
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Ashraf F I Nabhan 3 Objective This presentation reviews those techniques that enable the obstetrician to predict accurately the risks of respiratory distress syndrome (RDS) for the infant requiring premature delivery and to avoid the unnecessary tragedy of iatrogenic prematurity
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Ashraf F I Nabhan 4 How Did We Get Here? Prior to the now common practice of using ultrasound to establish gestational age and amniotic fluid studies to assess fetal pulmonary maturation, iatrogenic prematurity was an important clinical problem. Untimely or unwarranted intervention was responsible for 15 percent of cases of RDS.
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Ashraf F I Nabhan 5 Today’s Situation Modern Obstetric practice has shown a decline in iatrogenic prematurity and RDS. Several changes in clinical practice appear to have decreased the incidence of RDS due to iatrogenic prematurity The corner stone of those changes appear to be the increased availability of ultrasound and fetal lung maturity studies and advances in the application and interpretation of these diagnostic procedures
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Ashraf F I Nabhan 6 Available Options Quantitation of Pulmonary Surfactant Measurement of Surfactant Function Evaluation of Amniotic Fluid Turbidity Appropriate use of Ultrasonography
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Ashraf F I Nabhan 7 Quantitation of Pulmonary Surfactant: L/S Ratio It is the most valuable assay for the assessment of fetal pulmonary maturity. At 32 weeks the L/S ratio reaches 1. Lecithin then rises rapidly, and an L/S ratio of 2.0 is observed at 35 weeks. A ratio of 2.0 or greater has repeatedly been associated with pulmonary maturity.
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Ashraf F I Nabhan 8 Quantitation of Pulmonary Surfactant: L/S Ratio A mature L/S ratio predicted the absence of RDS in 98 percent of neonates. With a ratio of 1.5 to 1.9, approximately 50 percent of infants will develop RDS. Below 1.5, the risk of subsequent RDS increases to 73 percent. Thus, the L/S ratio, like most indices of fetal
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Fetal-Lung-Maturity - Assessment of Fetal Lung Maturity Dr....

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