Prenatal prediction of respiratory distress syndrome by multimodality approach using 3D lung ultrasound, lung-to-liver intensity ratio tissue histogram and pulmonary artery Doppler assessment of fetal lung maturity

Abstract

Objective: Studying the correlation of different lung parameters, using three dimensional ultrasound (3D US) with fetal lung maturity (FLM) to predict the development of neonatal respiratory distress syndrome (RDS). Methods: Three dimensional ultrasound was done to record the fetal lung volume (FLV), Fetal lung to liver intensity ratio (FLLIR) & the main pulmonary artery (MPA) blood flow parameters; pulsatility index (PI), resistive index (RI) and acceleration time -to- ejection time ratio (At/Et), to 218 women between 32 to 40 weeks gestational age within 24 h from labor. Results: Of 218 fetuses examined, final analysis was done for 143 fetuses. Thirty eight (26.5%) were diagnosed with RDS. The MPA PI and RI were significantly higher in fetuses diagnosed with RDS compared with those without (2.51 ± 0.33 and 0.90 ± 0.03 cm/s versus 1.96 ± 0.20 and 0.84 ± 0.01 cm/s; p value < 0.001 and <0.001 respectively). MPA At/Et was significantly lower (0.24 ± 0.04 vs 0.35 ± 0.04; p value < 0.001). FLLIR was significantly lower (1.04 ± 0.07 vs 1.18 ± 0.11; p value < 0.001), and the mean FLV which was significantly smaller (28.23 ± 5.63, vs 38.87 ± 4.68 cm3; p value < 0.001). Conclusion: Main pulmonary artery (PI, RI, At/Et ratio), FLIIR, and mean FLV can be used as reliable predictors of neonatal RDS. Advances in knowledge: 3D ultrasound VOCAL technique, ultrasound tissue histogram and pulmonary artery Doppler are reliable tools for prenatal prediction of fetal lung maturity.

The Role and Clinical Value of Optimized Fetal Main Pulmonary Artery Doppler Parameters in the Diagnosis and Prognosis Monitoring of Neonatal Respiratory Distress Syndrome

“…With the continuous progress of ultrasound diagnosis technology, the artifact of ultrasound in the lung can be adopted to reflect and infer the pathological changes of the lung [ 25 ]. It makes it possible to use lung ultrasound as the main means of diagnosing lung diseases in a clinic.…”

Fetal lung volume and pulmonary artery resistance index for prediction of neonatal respiratory distress syndrome

“…17 Guan et al reported significant correlations between gestational age and neonates with RDS. 12 18 Duncan et al conducted a prospective cohort study to ascertain the prognostic accuracy of the foetal pulmonary artery acceleration time/ejection time for the identification of newborn respiratory complications, and reported that gestational age at delivery was significantly associated with RDS with 85% predictive accuracy for RDS. 19 Additionally, Mohamed et al showed a statistically significant relationship between the occurrence of RDS and exact birth weight, which was considerably lower in those who had the condition.…”

Development of a deep learning-based grading model to evaluate fetal lung maturity from normal fetal lung ultrasound images

“…For ultrasound evaluation of fetal lung maturity, people prefer to use lung to compare with liver and placenta. [14,15] However, the human eye has relatively low resolution, poor repeatability, and is subject to the operator's experience. With the continuous deepening of mathematical algorithms and the beginning of the big data era, in recent years, more and more research has combined arti cial intelligence with medical undertakings, and intelligently recognized image information through computer extraction of image texture features, especially deep learning.…”