Acceleration/ejection time ratio in the fetal pulmonary artery predicts fetal lung maturity

Azpurua, Humberto; Norwitz, Errol R.; Campbell, Katherine; Funai, Edmund F.; Pettker, Christian M.; Kleine, M.J. de; Bahtiyar, Mert O.; Malkus, H; Copel, Joshua A.; Thung, Stephen

doi:10.1016/j.ajog.2010.01.075

Cited by 61 publications

(75 citation statements)

References 33 publications

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“…Our results differ from those published by Azpurua et al [4] , in which the values of the acceleration/ejection time ratio of the fetal pulmonary artery decreased as the lecithin/sphingomyelin ratio values increased, hence the probability of fetal lung maturity. We are unable to explain the reason for their results.…”

Section: Discussioncontrasting

confidence: 99%

“…Results: Forty-three patients were included in this study. The receiver operating characteristic curve demonstrated that a PATET cutoff of 0.3149 provided a specificity of 93% (95% CI 77-98%), a sensitivity of 73% (95% CI 48-89%), a negative predictive value of 87% (95% CI 70-95%), and a positive predictive value of 85% (95% CI 58-tion time and between the latter and fetal lung maturity testing in amniotic fluid [3,4] , we hypothesized that this method could accurately predict lung maturity. In this study, we sought to determine whether measuring the acceleration/ejection time ratio of the fetal main pulmonary artery Doppler waveform (PATET) could accurately predict the results of fetal lung maturity testing in amniotic fluid.…”

Section: Introductionmentioning

confidence: 99%

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Predicting Fetal Lung Maturity Using the Fetal Pulmonary Artery Doppler Wave Acceleration/Ejection Time Ratio

Schenone¹,

Samson²,

Jenkins³

et al. 2014

Fetal Diagn Ther

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Objective: To determine whether the acceleration/ejection time ratio of the fetal main pulmonary artery Doppler waveform (PATET) can accurately predict the results of fetal lung maturity testing in amniotic fluid. Methods: We prospectively studied pregnant women attending our ultrasound unit for clinically indicated fetal lung maturity testing. An ultrasound examination that included measurement of the PATET was performed before the results of the amniocentesis were reported. The results of the PATET and the surfactant/albumin ratio were compared, and a receiver operating characteristic curve was used to determine the PATET cutoff with the optimal sensitivity and specificity for predicting surfactant/albumin ratio results. p < 0.05 was considered statistically significant. Results: Forty-three patients were included in this study. The receiver operating characteristic curve demonstrated that a PATET cutoff of 0.3149 provided a specificity of 93% (95% CI 77-98%), a sensitivity of 73% (95% CI 48-89%), a negative predictive value of 87% (95% CI 70-95%), and a positive predictive value of 85% (95% CI 58-96%) for predicting immature surfactant/albumin ratio results. Conclusion: The PATET may provide a noninvasive means of determining fetal lung maturity with acceptable levels of sensitivity, specificity, and predictive values.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predicting Fetal Lung Maturity Using the Fetal Pulmonary Artery Doppler Wave Acceleration/Ejection Time Ratio

Schenone¹,

Samson²,

Jenkins³

et al. 2014

Fetal Diagn Ther

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“…This statement is contrary to Kim et al who claimed that an increased At/Et ratio was seen in association with RDS [1] (in which the fetus would have increased pulmonary resistance). Azpurua et al demonstrated an inverse relationship between amniocentesis derived lechithin/springomyelin ratio and main pulmonary artery Doppler At/Et ratio [6]. However, who developed RDS and those that did not) excluding those who delivered more than a certain interval after ultrasound measurement.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study by Kim et al suggested that measurement of the fetal pulmonary artery blood flow is altered in fetuses that develop RDS at birth [1]. Indeed, Kim, along with other researchers [6], have suggested that pulse wave Doppler sampling of the fetal MPA could be used as a screening tool to help identify fetuses that are at a greater risk for developing RDS.…”

Section: Introductionmentioning

confidence: 99%

Does corticosteroid therapy impact fetal pulmonary artery blood flow in women at risk for preterm birth?

et al. 2015

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Aim: Maternal corticosteroid administration in pregnancy is known to enhance fetal lung maturity in at risk fetuses. The aim of this study was to test the hypothesis that corticosteroid therapy alters fetal pulmonary blood flow in pregnancies at risk for preterm birth (PTB). Material and methods: We prospectively evaluated main fetal pulmonary artery (MPA) blood flow in pregnant women at risk for PTB and treated with corticosteroids (betamethasone), compared to an uncomplicated cohort without steroid therapy. The Doppler indices of interest included Peak Systolic Velocity (PSV), Resistive Index (RI), Pulsatility Index (PI), Systolic/Diastolic ratio (S/D ratio), Acceleration Time (AT), and Acceleration Time/Ejection Time Ratio (AT/ ET ratio), with the latter serving as the primary outcomes due to its stability irrespective of gestational age. Results: When compared with controls, fetuses treated with corticosteroids demonstrated significantly decreased pulmonary artery acceleration time (median: 28.89 (22.22-51.11) vs. 33.33 (22.20-57.00), p=0.006), while all other indices remained similar. We found no difference in pulmonary blood flow between fetuses who developed respiratory distress syndrome (RDS) and those that did not (31.56 ± 6.842 vs. 32.36 ± 7.265, p= 0.76). Conclusion: Our data demonstrate altered fetal pulmonary blood flow with corticosteroid therapy, possibly due to increased arterial elastance brought on by medication effect, which leads to the decreased acceleration time or possible gestational age affect. Contrary to a recent report, we did not observe any Doppler differences in fetuses with RDS, which underscores the need for further examination of this proposed association.

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“…Neonatal respiratory distress syndrome (RDS) refers to respiratory compromise presenting at or shortly after delivery and is related to a deficiency in pulmonary surfactant, a naturally occurring phospholipid that is required to decrease surface tension within the alveoli to prevent alveolar collapse. Respiratory distress syndrome remains a major cause of neonatal morbidity and mortality . It is primarily a disease of premature neonates, with an incidence and severity that are highly dependent on gestational age (GA) .…”

mentioning

confidence: 99%

Effect of Betamethasone on Fetal Pulmonary and Umbilical Artery Doppler Velocimetry and Relationship With Respiratory Distress Syndrome Development

Güngör

İlhan

Gültekin

et al. 2017

J of Ultrasound Medicine

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Acceleration/ejection time ratio in the fetal pulmonary artery predicts fetal lung maturity

Cited by 61 publications

References 33 publications

Predicting Fetal Lung Maturity Using the Fetal Pulmonary Artery Doppler Wave Acceleration/Ejection Time Ratio

Predicting Fetal Lung Maturity Using the Fetal Pulmonary Artery Doppler Wave Acceleration/Ejection Time Ratio

Does corticosteroid therapy impact fetal pulmonary artery blood flow in women at risk for preterm birth?

Effect of Betamethasone on Fetal Pulmonary and Umbilical Artery Doppler Velocimetry and Relationship With Respiratory Distress Syndrome Development

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