الفهرس 
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Abstract
SUMMARY
Aim of the study
The current study aimed to clarify the impact of maternal
and neonatal factors on total nucleated cell count of collected
umbilical cord blood of preterm delivery < 36 weeks completed
gestation.
Methodology
This cross sectional study included 40 newborns; 20 (50%)
were males and 20 (50%) were females, with GA of 32.77±2.485
weeks, birth weight 2120.83±500.862 gm, length 43.95±2.396 cm
and OFC was 32.07±1.558 cm. The APGAR score at 1 min
ranged between 4-8 with median 6, while at 5 min it ranged
between 7-9 with median 8.
Comprehensive history taking was done for all stressing
on: Pre-existing maternal problems; Fetal problem: and Natal
history.
Detailed clinical neonatal examination :Determination of
the gestational age using Ballard score , APGAR score at 1 & 5
minutes, Determination of birth weight, length and occipito -
frontal circumference and Cord and Placental examination and
weight.
Collection of cord blood : Two methods for collection of
umbilical cord blood were included: method 1, collection with a
blood bag; method 2, syringe-assisted and drain with an open
sterile container.
Laboratory investigations: maternal and neonatal ABO and
Rh blood group, CBC and TNC counting .
Results
Among the 40 newborns 20 (50%) were males and 20
(50%) were females, with GA of 32.77±2.485 weeks, birth weight
2120.83±500.862 gm, length 43.95±2.396 cm and OFC was
32.07±1.558 cm. The APGAR score at 1 min ranged between 4-8
with median 6, while at 5 min it ranged between 7-9 with median
8.
Maternal age was 27.37±1.41 years and ranged between 25-
30 years, mother weight ranged between 70-85 kg with mean±SD
of 77.85±3.73, mother Hb% ranged between 11-13.5 % with
mean±SD of 12.10±0.79, placental weight was 496.352±80.672
gm and cord length was 52.3± 110.7 cm. Seven neonates (17.5%)
delivered vaginally while 33 (82.5%) delivered by CS, 7 (17.5%)
had no anesthesia, 20 (50%) had spinal anesthesia and 13(32.5%)
had general anesthesia. Regarding resuscitation, O2 was used in
13 (32.5%) neonates while 27 (67.5%) neonates did not need O2
during resuscitation. Thirteen (32.5%) cord blood samples were
collected using Bag and 27 (67.5%) samples were collected using
syringe. No cord anomilies was detected in this study.
Regarding maternal factors, 6 (15%) mothers had
hypertension while only 4 (10%) had preeclampsia, 6 (15%) had
gestational DM, 12 (30%) had PROM and all of them did not have
fever during that pregnancy.
There was significant higher TNC levels in vaginal delivery
and when no anesthesia was used and this difference was highly
significant statistically (p=0.001). No significant diffrance in TNC
levels regarding method of blood collection or resussetation.
There was statistically significant higher TNC in mothers
with hypertention, preeclampsia and PROM (p=0.03, 0.001, 0.001
respectively). No significant difference in TNC regarding parity,
maternal blood group, RH or gestational DM was detected.
The TNC is positively correlated with gestational age,
neonatal weight, neonatal length and OFC, TLC and granulocytes.
There was significant negative correlation between TNC
and maternal weight was detected. A significant positive
correlation between TNC and placental weight, amount of cord
blood, APGAR 1min and APGAR 5min. there was non significant
correlation between TNC and mother age, mother Hb or cord
length.
Regarding cord CBC, highly significant positive correlation
between TNC and TLC and granulocytes were detected. Non
significant correlation between TNC and the rest of CBC
parameters was detected.
On performing the logistic regression; it shows that after
elimination of all other factors, there was highly statistically
significant association between higher TNC and GA, amount of
cord blood, mode of delivery, maternal preeclampsia, TLC and
granulocytes and a statistically significant association between
higher TNC and neonatal RH, maternal weight, placental weight
and maternal hypertension.