OC079: The down‐prioritized right liver lobe of the growth‐restricted fetus

Abstract

include the lecithin/sphingomyelin ratio (L/S) and the presence of phosphatidylglycerol (PG) in amniotic fluid. Sonographic markers have been described previously but have not been accurate to predict FLM. Fetal pulmonary artery flow velocity waveforms (FEPAF) changes are noticed with the advance of gestational age. The relationship between FEPAF and biochemical standard measurements of FLM has not been tested to date. We evaluated the correlation of the changes in FEPAF with FLM. Methods: We obtained FEPAF with color Doppler-guided spectral Doppler ultrasound in 25 fetuses at a median of 36 weeks’ gestation (range 34–39 weeks) prior to clinically indicated FLM amniocentesis. Acceleration/ejection time ratio (A/Et), systolic/diastolic (S/D) ratio, resistance index (RI) and pulsatility index (PI) were measured. Results were compared to GA, EFW, L/S measured by thin layer chromatography and PG by latex agglutination. Data was collected and analyzed using SPSS to calculate Spearman’s rho (rs) and Multivariate regression. Results: Three cases were excluded due to meconium or blood contamination of the samples. We found a significant correlation of A/Et and PI with increasing levels of L/S (rs =− 0.766, P < 0.001 and rs =− 0.5221, P < 0.005 respectively) however FEPAF also showed a significant correlation between PI with EFW and GA (rs =− 0.537, P < 0.005 and rs =− 0.518, P < 0.005 respectively). The significant correlation between A/Et and L/S levels remained after correcting for GA and EFW. Only four cases were negative for PG and in all A/Et index was high. Conclusions: Low A/Et is significantly correlated with high levels of L/S and presence of PG with no correlation to GA or EFW. This is a rapid and non-invasive procedure that could potentially be a helpful tool to determine FLM.