Fetal lung volume and pulmonary artery resistance index for prediction of neonatal respiratory distress syndrome

Background: As gestational age grows, the risk of newborn respiratory distress syndrome (RDS) diminishes because the lungs are the last foetal organs to properly mature. While neonatal RDS does not just occur following preterm births, it is often thought of as a disorder of premature babies. This study sought to determine how prenatal lung capacity and foetal Pulmonary artery resistance index (PARI) affected the probability that newborn RDS would occur. Methods: This prospective observational study was carried out on 200 pregnant women aged 20-35 years, with gestational age between 36-40 weeks and singleton pregnancy. According to neonatal outcome the patients were classified into two groups: group A: 26 cases with noenatal RDS and group B: 174 cases without neonatal RDS. All patients were subjected to 2D ultrasonography and 3D ultrasonography. Results: Fetal lung volume (FLV) is a significant predictor of neonatal RDS (AUC: 0.820, p <0.001), at a cut off value of ≤35, with 88.5% sensitivity and 68.4% specificity. PARI is not a significant predictor of neonatal RDS. 1 and 5 min Apgar score were significantly lower in neonates who developed RDS and those who didn’t (p<0.001). Conclusions: 3D FLV and estimated fetal weight measurement using ultrasonography may be a reliable non-invasive indicator of the incidence of newborn RDS in preterm pregnancies when the risk of RDS progression is present. FLV is a significant predictor for neonatal RDS at a cutoff for ≤35 cm3 with sensitivity 88.5% and specificity 68.4%

Could Obesity be a Triggering Factor for Endometrial Tubal Metaplasia to be a Precancerous Lesion?

Background & Aims. Endometrial tubal metaplasia (ETM) is mostly described in conjunction with unopposed estrogen levels, and its association with endometrial hyperplasia and endometrial carcinoma (EC) is striking. Obesity is a risk factor for endometrial hyperplasia and EC development. The aim of this study is to investigate the impact of BMI and serum estradiol level on expression of PAX-2, H-TERT, P16, Ki-67, and P53 in studied ETM in reference to benign endometrium and EC. Methods. The study was conducted on the following groups: group (1) consists of 57 cases that had endometrial biopsies with histologically demonstrable ETM (typical or atypical) and all were subjected to serum estradiol levelling and body mass index (BMI) evaluation; group (2) had adjacent benign endometrial tissue as control; group (3) consists of 52 cases of conventional endometrial carcinoma and 16 serous carcinoma paraffin blocks which were collected and reevaluated. All included groups were immunostained for PAX-2, H-TERT, p16, ki67, and p53. Results. The relation between BMI and serum estradiol level in group 1 and PAX-2, H-TERT, P16, and p53 was statistically significant, while their relation with atypia and ki67 expression was insignificant. Twenty-three ETM cases (40.4%) out of group 1 were all (100%) obese, 87% had high serum estradiol level, and 73.9% were postmenopausal and had a similar immunohistochemical profile as EC cases (group 3). Conclusions. The presence of ETM regardless of the histologic atypia in obese postmenopausal patients with high serum estradiol level is an alarming sign. This implies that ETM might not be as benign as generally accepted, as under certain clinical conditions, it may turn into a potential premalignant lesion

Role of transperineal ultrasound measurements in women with prolonged second stage of labor as predictors of the mode of delivery

Aim of the work: To assess the clinical significance of transperineal ultrasound measurements, the angle of progression and the head progression distance in prediction of the mode of delivery in women with prolonged second stage of labor. Subjects and methods: 60 women with a live singleton fetus at full term who presented with prolonged second stage of labor were enrolled in our study. Transperineal ultrasound was used for determination of both angle of progression and head progression distance. We statistically analyzed the relationship between the ultrasound measurements and the different modes of delivery. Results: 32 women had spontaneous vaginal delivery, 13 women had assisted vaginal delivery using vacuum extraction and the remaining 15 women had a cesarean section. A statistically significant difference was found between the angle of progression and the mode of delivery, however there was no statistically significant difference between head progressive distance and different modes of delivery. The angle of head progression correlated with the mode of delivery using logistic regression analysis with a probability of 85.5% for an angle of 120°. Conclusion: Angle of progression measured by transperineal ultrasound, is an easy, simple, reliable, and noninvasive method for prediction of mode of delivery in women with prolonged second stage of labor rather than head progression distance