Prenatal prediction of pulmonary hypoplasia

Triebwasser, Jourdan E.; Treadwell, Marjorie C.

doi:10.1016/j.siny.2017.03.001

Cited by 32 publications

(30 citation statements)

References 47 publications

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“…Various ultrasound investigations have focused on the fetal lung, such as lung area [3,8] and lung volume [9,10], to evaluate the fetal lung development. In terms of the fetal thorax, some studies mention the usefulness of fetal thoracic area [8], thoracic circumference [2,3] and thoracic volume [10] in prenatal diagnosis, but few systematic studies have established the fetal thoracic nomogram and assess the application in diagnosing thoracic malformations. Ultrasound could diagnose congenital thoracic malformations such as congenital pleural effusion, CHD and bronchopulmonary sequestration before 16 gestational weeks, which is bene cial for prenatal counseling and making early decisions concerning deadly fetal malformations [5].…”

Section: Discussionmentioning

confidence: 99%

“…The inclusion criteria for the normal group included (1) singleton pregnancy, (2) precise gestational age (GA) based on last menstrual period and evaluated via ultrasonography before 20 gestational week, (3) GA is between 13 and 40 weeks, (4) absence of any fetal malformation, and (5) low-risk pregnancy without other maternal or placental complications. Exclusion criteria included (1) multifetal pregnancy,…”

Section: Sample and Protocolmentioning

confidence: 99%

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Reference Range of Fetal thorax using Two-dimensional and Three-dimensional Ultrasound VOCAL Technique and Application in Fetal Thoracic Malformations

Lian

Zheng

et al. 2020

Preprint

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Background: To establish the normal reference range of fetal thorax by two-dimensional (2D) and three-dimensional (3D) ultrasound VOCAL technique and evaluate the application in diagnosing fetal thoracic malformations. Methods: A prospective cross-sectional study was undertaken involving 1077 women who have a normal singleton pregnancy at 13-40 weeks gestational age (GA). 2D ultrasound and 3D ultrasound VOCAL technique were utilized to assess fetal thoracic transverse diameter, thoracic anteroposterior diameter, thoracic circumference, thoracic area, lung volume, thoracic volume and lung-to-thoracic volume ratio. The nomograms of 2D and 3D fetal thoracic measurements were created to GA. 50 cases were randomly selected to calculate intra- and inter-observer reliability and agreement. In addition, the case groups including congenital skeletal dysplasia (SD) (15), congenital diaphragmatic hernia (CDH) (30), pulmonary sequestration (PS) (25) and congenital cystic adenomatoid malformation (CCAM) (36) were assessed by the nomograms and followed up subsequently.Results: Both 2D and 3D fetal thoracic parameters increased with GA using a quadratic regression equation. The intra- and inter-observer reliability and agreement of each thoracic parameter were excellent. 2D fetal thoracic parameters can initially evaluate the fetal thoracic development and diagnose the skeletal thoracic deformity, and lung volume, thoracic volume and lung-to-thorax volume ratio are practical to diagnose and differentiate CDH, PS and CCAM.Conclusion: We have established the normal fetal thoracic reference range at 13-40 weeks, which has a high value in diagnosing congenital thoracic malformations.

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Section: Discussionmentioning

confidence: 99%

Section: Sample and Protocolmentioning

confidence: 99%

Reference Range of Fetal thorax using Two-dimensional and Three-dimensional Ultrasound VOCAL Technique and Application in Fetal Thoracic Malformations

Lian

Zheng

et al. 2020

Preprint

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“…Pulmonary hypoplasia is a rare condition, affecting 9–11/10,000 live births ( 1 ). The pathophysiology of pulmonary hypoplasia is a reduction in the number of lung cells, airways, and alveoli, resulting in a decrease in organ size and weight.…”

Section: Discussionmentioning

confidence: 99%

“…These factors are highly correlated with insufficient gas exchange ( 4 ). Diagnosis of pulmonary hypoplasia is based on clinical findings of respiratory distress occurring almost secondary to other fetal anomalies ( 1 , 10 ). In addition, low-intensity fetal lung on MRI could be the clues of pulmonary hypoplasia ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary Hypoplasia Caused by Fetal Ascites in Congenital Cytomegalovirus Infection Despite Fetal Therapy

et al. 2017

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We report two cases of pulmonary hypoplasia due to fetal ascites in symptomatic congenital cytomegalovirus (CMV) infections despite fetal therapy. The patients died soon after birth. The pathogenesis of pulmonary hypoplasia in our cases might be thoracic compression due to massive fetal ascites as a result of liver insufficiency. Despite aggressive fetal treatment, including multiple immunoglobulin administration, which was supposed to diminish the pathogenic effects of CMV either by neutralization or immunomodulatory effects, the fetal ascites was uncontrollable. To prevent development of pulmonary hypoplasia in symptomatic congenital CMV infections, further fetal intervention to reduce ascites should be considered.

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Fetal arthrogryposis: Challenges and perspectives for prenatal detection and management

Filges

Tercanli

Hall

2019

American J of Med Genetics Pt C

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Antenatal identification of fetuses with multiple congenital contractures or arthrogryposis multiplex congenita (AMC) may be challenging. The first clinical sign is often reduced fetal movement and/or contractures, as seen on prenatal ultrasounds. This can be apparent at any point, from early to late pregnancy, may range from mild to severe involvement, with or without associated other structural anomalies. Possible etiologies and their prognosis need to be interpreted with respect to developmental timing. The etiology of AMC is highly heterogeneous and making the specific diagnosis will guide prognosis, counseling and prenatal and perinatal management. Current ultrasound practice identifies only approximately 25% of individuals with arthrogryposis prenatally before 24 weeks of pregnancy in a general obstetrics care population. There are currently no studies and guidelines that address the question of when and how to assess for fetal contractures and movements during pregnancy. The failure to identify fetuses with arthrogryposis before 24 weeks of pregnancy means that physicians and families are denied reproductive options and interventions that may improve outcome. We review current practice and recommend adjusting the current prenatal imaging and genetic diagnostic strategies to achieve early prenatal detection and etiologic diagnosis. We suggest exploring options for in utero therapy to increase fetal movement for ongoing pregnancies.

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Prenatal prediction of pulmonary hypoplasia

Cited by 32 publications

References 47 publications

Reference Range of Fetal thorax using Two-dimensional and Three-dimensional Ultrasound VOCAL Technique and Application in Fetal Thoracic Malformations

Reference Range of Fetal thorax using Two-dimensional and Three-dimensional Ultrasound VOCAL Technique and Application in Fetal Thoracic Malformations

Pulmonary Hypoplasia Caused by Fetal Ascites in Congenital Cytomegalovirus Infection Despite Fetal Therapy

Fetal arthrogryposis: Challenges and perspectives for prenatal detection and management

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