Abstract
Purpose: To evaluate the role of fetal pulmonary artery Doppler indices and quantitative ultrasound texture analysis of the fetal lung (quantus FLM) in prediction of neonatal respiratory distress syndrome. Method: This Observational prospective cross sectional study included 40 pregnant women between 28 and 40 weeks gestation. The diagnostic accuracy of MPA Doppler measurements (pulsatility index (PI), resistance index (RI) and acceleration time/ejection time (AT/ET) for diagnosis of neonatal RDS was tested by comparing the Doppler findings with the clinical outcome. Results: Of the 40 eligible fetuses, 9 (22%) developed neonatal RDS There was a significant correlation between the AT/ET and the development of the RDS as the AT/ET was significantly lower in the RDS +ve group (mean 0.27) in comparison to the RDS-ve group (mean 0.34) (P 0.001). While both PI and RI showed no statistically significant difference in between the two groups. A cutoff value of 0.3 for AT/ET predicted the development of RDS (sensitivity: 77.78%, specificity: 83.87%). Quantus FLM predicted the development of neonatal RDS with high sensitivity, specificity, positive predictive value, negative predictive value and accuracy (88.98%, 90.32%, 72.7%, 96.6% and 90%respectively). The area under curve was 0.896. Conclusion: Neonatal RDS can be predicted using the MPA AT/ET and quantitative ultrasound texture analysis of the fetal lung (quantus FLM) with high sensitivity and specificity.
Highlights
7.3% of all live births in Egypt are premature, meaning birth before 37 weeks of gestation [1]
Twentyfive cases were excluded from the study: 14 patients of them gave birth more than 48 hours after the ultrasound examination, 8 cases had respiratory distress due to causes, 2 cases were discarded for missed neonatal data and one case for suboptimal ultrasound data
Our results showed that quantus insonation angle could not be achieved; we did not FLM predicted the development of neonatal Respiratory distress syndrome (RDS) with high include pulmonary artery velocimetry parameters (PSV, end-diastolic maximum velocity (EDV), sensitivity, specificity, positive predictive value, negative S/D) in our results
Summary
7.3% of all live births in Egypt are premature, meaning birth before 37 weeks of gestation [1]. Respiratory distress syndrome (RDS) of the newborn, called hyaline membrane disease which is the most common cause of respiratory distress in premature infants, correlating with structural and functional lung immaturity and it is the commonest cause of neonatal mortality [4]. In those who are born prematurely, the obstetrician has to balance the benefits of a preterm birth on both mother and child against the obvious risks of preterm births for the neonates. Amniocentesis is an invasive procedure and is associated with a small but real risk to the pregnancy, including
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