OP08.01: Prenatal prediction of fetal lung maturity using pulmonary artery Doppler and 3D ultrasound

Aboulghar, M.; Khalifa, Yasmin Essameldin Abdalla; Hamed, Soha Talaat; Tomerak, Rania Hosny; Kamal, Eman

doi:10.1002/uog.20718

Cited by 3 publications

(5 citation statements)

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“…Our results were in agreement with Abdelhamid et al, [1] ; Jose et al, [13] ; Mohamed et al, [14] ; Osama et al, [15] ; Aboulghar et al, [16] and Büke et al, [17] . All of them had similar study designs (comparing the fetal main pulmonary artery Doppler with Clinical outcome).…”

Section: Discussionsupporting

confidence: 93%

The Role of Fetal Pulmonary Artery Doppler in Prediction of Fetal Lung Maturity

GUIRGUIS¹,

Ibrahim

2022

The Medical Journal of Cairo University

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Background: The pulmonary system is the last fetal organ system required for extra uterine life to become functionally mature, and respiratory distress syndrome (RDS), related to pulmonary surfactant deficiency, remains a major morbidity and mortality. Aim of Study:Was to emphasize the role of fetal pulmonary artery Doppler in prediction of fetal lung maturity by comparing fetal pulmonary artery color Doppler results with gestational age and neonatal outcome.Patients and Methods: This observational prospective cross sectional study was conducted at Ain Shams University Obstetricians & Gynecologists Hospital after approval from the hospital research ethics committee for 8 months. The study included sixty pregnant women aged 18-41 years between 28 to 40 weeks gestational age of pregnancy, had been admitted for elective cesarean, or attending the delivery unit either in active labor or indicated for selective cesarean. Ultrasound scans were performed within 48 hours for pregnant women from 28 weeks to 40 weeks.Results: Main pulmonary artery (At/Et ratio), fetal lung to liver echogenicity, free particles in amniotic fluid and placental grading were positively correlated with lung maturity.It identified main pulmonary artery At/Et ratio (cutoff >!0.30) with (92.5% sensitivity, 87.2% specificity), as reliable predictors of neonatal RDS. Also our study showed that gestational age, free particles of amniotic fluid, fetal lung to liver echogenicity and placental grading were significantly correlated with development of neonatal respiratory distress syndrome as gestational age was lower on those who eventually developed neonatal RDS (p-value <0.001). Furthermore, combination of these measures has greater sensitivity & negative predictive value than when either measure was used alone. Therefore, these measurements might be alternatives to invasive procedures for assessment of fetal lung maturity before delivery. Conclusion:Main pulmonary artery (MPA) At/Et ratio, together with fetal lung to liver echogenicity, free particles in amniotic fluid and placental grading can be used as noninvasive accurate methods for prediction of neonatal respiratory distress syndrome (RDS) and fetal lung maturity (FLM), with

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Section: Discussionsupporting

confidence: 93%

The Role of Fetal Pulmonary Artery Doppler in Prediction of Fetal Lung Maturity

GUIRGUIS¹,

Ibrahim

2022

The Medical Journal of Cairo University

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“…This is in keeping with [ 7 ] were the MPA PI and RI were remarkably higher (2.27 ± 0.23 and 0.8 ± 0.11 cm s −1 versus 2.18 ± 0.23 and 0.76 ± 0.09 cm s −1 ; p : 0.003 and 0.002, respectively), whereas PSV was significantly lower in fetuses with RDS (65.05 ± 5.33 cm s −1 versus 67.21 ± 4.8 cm s −1 ; p : 0.002). Our results are also matching with [ 6 ] were the MPA PI and RI were remarkably higher in fetuses who developed RDS as compared to those with who didn’t (2.51 ± 0.33 and 0.90 ± 0.03 cm s −1 versus 1.96 ± 0.20 and 0.84 ± 0.01 cm s −1 ; p value < 0.001 and < 0.001 respectively). However, according to [ 15 ] other Doppler indices including RI, PI, PSV and S/D were not different between RDS (+) and RDS (−) fetuses.…”

Section: Discussionsupporting

confidence: 91%

“…In our study the PI cut off value of 2.47 (AUC = 0.797, 95% CI; 0.692–0.902, p < 0.001) revealed higher sensitivity (80.8%), yet with much lower specificity (52.3%), while the RI revealed cut off value of 0.8962 (AUC = 0.818, 95% CI; 0.720–0.916, p < 0.001) revealed lower sensitivity (69.2%) and specificity (81.8%) as compared to those of At/Et ratio. This is in keeping with [ 6 ] study were the optimum cut-off was 2.33 for MPA PI (AUC = 0.96; p < 0.001) with accuracy 94.4% while the MPA RI was 0.89 for (AUC = 0.94; p < 0.001with accuracy 88.1%.…”

Section: Discussionsupporting

confidence: 89%

“…Several investigators have used Doppler velocimetry to measure fetal pulmonary blood flow in pulmonary artery and peripheral branches, but the rate of accurate Doppler recordings is moderate (77-84%), and the results are widely disparate [5], because as gestation progresses, the Doppler velocity waveform in the fetal MPA change. Many trials have studied the relation between fetal pulmonary artery Doppler waveforms and fetal pulmonary hypoplasia [6]. Fetal pulmonary artery acceleration time/ejection time ratio has a strong correlation with the increasing fetal gestational age [7].…”

Section: Introductionmentioning

confidence: 99%

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Sonographic prediction of fetal main pulmonary artery (MPA) Doppler indices of lung maturity and neonatal respiratory distress syndrome (RDS) development

et al. 2023

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Purpose The aim of this study is to highlight the predictive role of perinatal fetal main pulmonary artery (MPA) Doppler measurements in neonatal respiratory distress syndrome development. Respiratory distress syndrome (RDS) is one of the lead causes of neonatal respiratory distress as well as neonatal death. Thus, it seems logic to evaluate fetal lung maturity before labour. Methods The study is a prospective cohort study performed in tertiary hospital over a period of one-year duration. 70 pregnant ladies between 34 and 38 weeks of gestation were referred for fetal echo, when pregnancy was considered a high risk. A trained radiologist using dedicated ultrasound machine with updated obstetric and fetal echo software performed the fetal echo. Doppler mode and curvilinear probe of 5.7 MHz transducer. Pediatric neonatologist observed the neonatal outcome post-natally. Results A total of 70 pregnant patients with risk factors underwent fetal echo, 26/70 (37.1%) were diagnosed with RDS conforming to the neonatal criteria. The mean acceleration time/ejection time ratio (At/Et ratio) of the fetal pulmonary artery was significantly reduced in fetuses that subsequently developed RDS than those without RDS. Contrarily, the mean pulsatility index (PI), resistance index (RI), and peak systolic velocity (PSV) of the fetal pulmonary artery were significantly high in fetuses who later developed RDS than in those who did not. Conclusion Fetal MPA Doppler measurements have a major role in anticipating the development of neonatal RDS in preterm and early term neonates.

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“…A Case-Control Study at central venous vessels (Ductus venosus and inferior vena cava), and with cardiotocography [4]. In the fetus, the Doppler evaluation of the main pulmonary artery has been shown to be useful in the analysis of the impedance of such vascular systems and changes in those variables have been demonstrated to correlate with gestational age, fetal lung maturity and neonatal outcomes [8,[14][15][16][17][18][19][20]. Adding central arterial Doppler (aortic and pulmonary artery waveforms) may improve management of the fetus with FGR, but studies are lacking on the prospective clinical evaluation of the ventricular outflow tracts Doppler in FGR fetuses.…”

Section: Comparison Of Fetal Main Pulmonary Artery Doppler Wave Formsmentioning

confidence: 99%

Comparison of Fetal Main Pulmonary Artery Doppler Wave Forms between Normally Grown and Growth Restricted Fetuses: A Case-Control Study

2020

ARCH Women Health Care

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OP08.01: Prenatal prediction of fetal lung maturity using pulmonary artery Doppler and 3D ultrasound

Cited by 3 publications

References 0 publications

The Role of Fetal Pulmonary Artery Doppler in Prediction of Fetal Lung Maturity

The Role of Fetal Pulmonary Artery Doppler in Prediction of Fetal Lung Maturity

Sonographic prediction of fetal main pulmonary artery (MPA) Doppler indices of lung maturity and neonatal respiratory distress syndrome (RDS) development

Comparison of Fetal Main Pulmonary Artery Doppler Wave Forms between Normally Grown and Growth Restricted Fetuses: A Case-Control Study

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