Lecithin/sphingomyelin ratio and lamellar body count for fetal lung maturity: a meta-analysis

Besnard, Anouk E.; Wirjosoekarto, Soetinah; Broeze, Kimiko A.; Opmeer, Brent C.; Mol, Ben Willem J.

doi:10.1016/j.ejogrb.2013.02.013

Cited by 35 publications

(31 citation statements)

References 26 publications

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“…The main finding of this large multicenter study is that quantitative texture analysis of fetal lung ultrasound images predicted NRM with a similar accuracy to that of laboratory tests using amniotic fluid, which have reported sensitivities and specificities ranging from 74% to 89% and from 54% to 89% respectively [9, 24, 25], although a wide range of figures has been reported (Table 5 and Table 3S). Furthermore, the risk of respiratory neonatal morbidity observed in this study was similar to that reported in a recently published large cohort study of late preterm and early term infants (Table 4S).…”

Section: Commentmentioning

confidence: 52%

“…Assessment of fetal lung maturity for the prediction of NRM may be relevant, particularly after 34 weeks of gestation, when the risk of NRM ranges from 5% to 20%, to better assess the risk/benefit ratio of elective delivery in late pregnancy complications [4-6] and/or with the use of corticosteroids [7, 8]. In current clinical practice, the evaluation of the risk of NRM relies on the study of different components of the amniotic fluid that requires an amniocentesis [9, 10]. …”

Section: Introductionmentioning

confidence: 99%

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Prediction of neonatal respiratory morbidity by quantitative ultrasound lung texture analysis: a multicenter study

Palacio¹,

Bonet‐Carne²,

Cobo³

et al. 2017

American Journal of Obstetrics and Gynecology

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Background Prediction of neonatal respiratory morbidity may be useful to plan delivery in complicated pregnancies. The limited predictive performance of the current diagnostic tests together with the risks of an invasive procedure restricts the use of fetal lung maturity assessment. Objective The objective of this study was to evaluate the performance of quantitative ultrasound texture analysis of the fetal lung (quantusFLM) to predict neonatal respiratory morbidity in preterm and early-term (<39.0 weeks) deliveries. Study Design This was a prospective multicenter study conducted in 20 centers worldwide. Fetal lung ultrasound images were obtained at 25.0-38.6 weeks of gestation within 48 hours of delivery, stored in Digital Imaging and Communication in Medicine format, and analyzed with quantusFLM. Physicians were blinded to the analysis. At delivery, perinatal outcomes and the occurrence of neonatal respiratory morbidity, defined as either respiratory distress syndrome or transient tachypnea of the newborn, were registered. The performance of the ultrasound texture analysis test to predict neonatal respiratory morbidity was evaluated. Results A total of 883 images were collected, but 17.3% were discarded because of poor image quality or exclusion criteria, leaving 730 observations for the final analysis. The prevalence of neonatal respiratory morbidity was 13.8% (101/730). The quantusFLM predicted neonatal respiratory morbidity with a sensitivity, specificity, and positive and negative predictive values of 74.3% (75/101), 88.6% (557/629), 51.0% (75/147), and 95.5% (557/583), respectively. Accuracy was 86.5% (632/730), and the positive and negative likelihood ratios were 6.5 and 0.3, respectively. Conclusion The quantusFLM predicted neonatal respiratory morbidity with an accuracy similar to that previously reported for other tests with the advantage of being a non-invasive technique.

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Section: Commentmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Prediction of neonatal respiratory morbidity by quantitative ultrasound lung texture analysis: a multicenter study

Palacio¹,

Bonet‐Carne²,

Cobo³

et al. 2017

American Journal of Obstetrics and Gynecology

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“…Use of steroids should be reduced by adequate preterm birth risk assessment and avoidance of unnecessary early elective CS. In some cases when an early CS is needed, establishment of fetal lung maturity may be better than giving steroids to all women [32]. There is little evidence that delivering preterm infants by CS rather than allowing vaginal delivery improves outcome.…”

Section: Prenatal Carementioning

confidence: 99%

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

et al. 2019

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As management of respiratory distress syndrome (RDS) advances, clinicians must continually revise their current practice. We report the fourth update of “European Guidelines for the Management of RDS” by a European panel of experienced neonatologists and an expert perinatal obstetrician based on available literature up to the end of 2018. Optimising outcome for babies with RDS includes prediction of risk of preterm delivery, need for appropriate maternal transfer to a perinatal centre and timely use of antenatal steroids. Delivery room management has become more evidence-based, and protocols for lung protection including initiation of CPAP and titration of oxygen should be implemented immediately after birth. Surfactant replacement therapy is a crucial part of management of RDS, and newer protocols for its use recommend early administration and avoidance of mechanical ventilation. Methods of maintaining babies on non-invasive respiratory support have been further developed and may cause less distress and reduce chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease, although minimising time spent on mechanical ventilation using caffeine and, if necessary, postnatal steroids are also important considerations. Protocols for optimising general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome.

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“…Neonatal respiratory morbidity is not restricted to very preterm births and remains high among late‐preterm and early‐term infants born before 39 weeks' gestation. Fetal lung maturity (FLM) is determined mainly by pulmonary surfactant and it can only be assessed with laboratory tests on amniotic fluid. The need for amniocentesis has resulted in a decline in the use of this information clinically.…”

Section: Introductionmentioning

confidence: 99%

Quantitative ultrasound texture analysis of fetal lungs to predict neonatal respiratory morbidity

Bonet‐Carne

Palacio

Cobo

et al. 2015

Ultrasound in Obstet & Gyne

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Lecithin/sphingomyelin ratio and lamellar body count for fetal lung maturity: a meta-analysis

Cited by 35 publications

References 26 publications

Prediction of neonatal respiratory morbidity by quantitative ultrasound lung texture analysis: a multicenter study

Prediction of neonatal respiratory morbidity by quantitative ultrasound lung texture analysis: a multicenter study

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

Quantitative ultrasound texture analysis of fetal lungs to predict neonatal respiratory morbidity

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