Abstract
Pulmonary hypoplasia is common in the perinatal period and causes death in newborn infants. It is commonly associated with a number of malformation syndromes. Various parameters are used to estimate pulmonary hypoplasia at fetal autopsy including Lung Weight Body Weight ratio (LW:BW), Radial Alveolar Count (RAC) and DNA estimation. This study was carried out as a retrospective analysis of 108 lung specimens of fetuses with congenital anomalies for a period of five years. All terminated fetuses with anomalies were received with 10% formalin. An inverted Y-shaped incision was made on the fetus to remove the lungs. Lung weight and body weight were measured and the ratio was calculated. Morphometric estimation of RAC was done microscopically by counting the number of alveoli using the Q capture software. RAC was calculated based on gestational age. Among the restrictive lung diseases, pulmonary hypoplasia by the LW:BW ratio was prevalent in 43% while the same by RAC was 19%. Similarly, pulmonary hypoplasia by the LW:BW ratio was prevalent in 35% while the same by RAC was 26% among cases with non restrictive lung diseases. Oligohydramnios showed the highest prevalence of pulmonary hypoplasia (23.7%), followed by renal anomalies (16.9%) and CNS anomalies (15.2%). Pulmonary hypoplasia is a common occurrence in many congenital anomalies, premature rupture of membranes, and hydrops fetalis. Identifying the anomaly during the intrauterine period will help to anticipate and accordingly manage the baby in the postpartum period. Early diagnosis of correctable condition like oligohydramnios will also help in the early intervention and prevention of pulmonary hypoplasia.
Highlights
Pulmonary hypoplasia can be defined as arrested or incomplete development of the lungs
Among the restrictive lung diseases, pulmonary hypoplasia by the Lung Weight:Body Weight ratio (LW):BW ratio was prevalent in 43% while the same by Radial Alveolar Count (RAC) was 19%
Pulmonary hypoplasia by the LW:BW ratio was prevalent in 35% while the same by RAC was 26% among cases with non restrictive lung diseases
Summary
Pulmonary hypoplasia can be defined as arrested or incomplete development of the lungs. A number of growth factors are necessary for appropriate lung development, including appropriate space, normal respiratory motion, and adequate fluid, which normally distends the developing lung. Pulmonary hypoplasia can result when any one or a combination of these factors is absent or impaired [1]. Pulmonary hypoplasia is common in the perinatal period and is a significant cause of death in newborn infants. Pulmonary hypoplasia in newborns is commonly associated with a number of malformation syndromes that commonly include diaphragmatic hernia and renal agenesis or dysgenesis. Other associations include skeletal muscle disorders, exomphalos, skeletal dysplasia, hydrops fetalis, trisomy 18, and prolonged rupture of the membranes
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