Correlation between myometrial thickness and the latency interval in preterm premature rupture of membranes

In order to predict the time of labor in patients with preterm premature rupture of membrane [PPROM], different factors have been studied resulting in different detection rates. Recently, sonographic measurement of myometrial thickness [MT] has been introduced and studied as an applicable and noninvasive method in predicting the length of latency interval [LI] of labor [the period from PPROM to start of labor]. The objective of our study was to determine the correlation between MT and LI in pregnant women with PPROM led to oligohydramnios. This was a cross-sectional study on 24 cases with PPROM. The sonographic measurement of myometrial thickness and the latency interval of patients with PPROM without labor pain were recorded. Gestational age was between 26-34 weeks and amniotic fluid index [AFI] was less than 5 percentile. The data were analyzed using SPSS software. The mean +/- SD maternal age was 29.2 +/- 1.2 years. The AFI in all women was less than 5% percentile of normal fluid for that gestational age. The mean +/- SD of gestational age was 29.1 +/- 2.2 weeks. The mean +/- SD of MT was 6.5 +/- 1.5 mm interiorly, 7.9 +/- 4.2 mm fundal, 6.6 +/- 1.7 mm in the lower segment and 7.8 +/- 2.2 mm laterally. The mean LT was 545 +/- 4.7 hours. Our study showed that there is no significant correlation between MT and LI in pregnant women with PPROM and reduced AFI

[Evaluation of mortalitiy rate and complications of neonatal respiratory distress syndrome treated with mechanical ventilation and surfactant therapy]

Since the first successful report of endotracheal surfactant administration in 10 neonates with RDS in 1980 by Fujiwara, several studies have shown that surfactant administration would decrease neonatal mortality and morbidity such as Pulmonary Air leak [PAL] or Brochopulmonary dysplasia [BPD]. This study was conducted in NICU of Mahdieh hospital between March 2002 and March 2005 to evaluate the mortalitiy rate and complications of neonates with RDS who have recieved mechanical ventilation and surfactant. Between March 2002 and March 2005, 124 neonates [36% females and 64% Males] with RDS, admitted in NICU were enrolled in this study. 25% of the patients were fullterm and 75% were preterm. All of them underwent mechanical ventilation due to either O2 requirement of more than 60% [through Hood] or arterial PH of less than 7.25. Surfactant was administered as 4 cc/kg per dose [Maximum 2 doses] if mean Air way pressure [MAP] was equal or more than 7 cmH[2o] or fiO[2] equal or more than 40%. Neonatal Mortality Rate [NMR] in these 124 patients was 27%. PAL was noted in 23.3% and BPD in 12.9% of cases. This study showed that with administration of surfactant the incidence of NMR was the same as several previous studies, albeit BPD incidence was lower and the incidence of PAL was higher than that of recent studies. Higher incidence of PAL may be due to late low dose surfactant administration or the quality of medical and nursing care, which must be impressed. The lower incidence of BPD in our study may be resulted from preliminary administration of prenatal dexamethasone