Combined Fetal Pulmonary Artery Doppler and Proximal Humeral Ossification center for prediction of Neonatal Respiratory Distress Syndrome at term: a Cohort Prospective Study

Abstract

Background: Fetal lung maturity is one of the huge dilemmas since a long time ago. Timing of the delivery is crucial for safe fetal delivery since verification of pulmonary maturity diminishes the respiratory morbidity possibility. Recently Pulmonary artery indices have been used to predict the possibility of RDS especially in early term. Together with humeral ossification center which has a remarkable value in estimation of term gestation, both of them can help prediction of fetal lung maturity. Aim of the Work: utilizing PHE with pulmonary artery Doppler indices for accurate prediction of fetal respiratory distress syndrome. The use of PHE in prediction of term gestation. Patients and Methods: Our study included 115 uncomplicated singleton pregnant women with gestational age between 37 to 40 weeks patients from Al-Azhar University Ob/Gyn hospitals during the period from November 2019 to October 2020. The ultrasound scans were done inside a 24 hours interval before delivery with Cesarean section. After delivery, the neonatal APGAR score at 1, 5 minutes, fetal diagnosis with RDS, any NICU admission were recorded respectively. Results: Pulmonary artery RI and PHE had statistically significant diagnostic performance in predicting fetal distress. PHE of ≤1.95 had highest diagnostic characteristics in predicting fetal distress. Among Pulmonary Artery Doppler, RI of ≥0.79 had highest diagnostic characteristics. Conclusion: PHE and Pulmonary artery R.I could predict fetal distress. Pulmonary artery indices and PHE combination (sum) predicted fetal distress better than using pulmonary indices alone. Presence of PHE confirms term gestation.