Fetal Pulmonary Artery Doppler Research Articles

Effect of maternal asthma on fetal pulmonary artery Doppler parameters: a case-control study.

To compare fetal pulmonary artery Doppler parameters between pregnant women with asthma and healthy pregnant women. This prospective, cross-sectional study was conducted on 50 pregnant women diagnosed with asthma and 61 healthy pregnant women. Fetal pulmonary artery Doppler parameters and the fetal main pulmonary artery acceleration time/ejection time (PATET) ratio were compared between the study and control groups. Thereafter, the study group was divided into two subgroups as non-severe and severe asthma. PATET ratio was compared between the subgroups. The fetal main pulmonary artery acceleration time was 25 ms in pregnant women with asthma and 33 ms in the healthy group, indicating a statistically significant difference (p=0.001). The acceleration time/ejection time ratio was statistically lower in the asthma group (0.185 vs. 0.240, p<0.001). The acceleration time/ejection time ratio was 0.172 in patients with severe asthma and 0.195 ms in the non-severe study group (p=0.156). In the maternal asthma group, the PATET ratio of those who went to the NICU due to respiratory distress was also 0.188, and the PATET ratio of those who went to the NICU for other reasons was 0.269 (p=0.053). Fetal pulmonary artery acceleration time and PATET decreased statistically in pregnant women with severe or non-severe asthma. Maternal asthma is associated with changes in pulmonary Doppler parameters in the fetus.

Fetal pulmonary artery Doppler's predictive usefulness in newborn respiratory distress syndrome

Fetal pulmonary artery Doppler's predictive usefulness in newborn respiratory distress syndrome

Association of maternal serum vitamin D level with fetal pulmonary artery Doppler indices and neonatal respiratory distress syndrome.

Respiratory distress syndrome (RDS) is potentially fatal in infants. The present study investigated the association of maternal serum vitamin D level with fetal pulmonary artery Doppler indices and neonatal RDS. This cross-sectional-analytical study was conducted on 260 mothers admitted for delivery. The maternal serum 25-hydroxyvitamin D level was measured and fetal main pulmonary artery Doppler indices were evaluated. The neonate's weight, apgar score, RDS, Umbilical cord arterial pH and neonatal intensive care unit admission were recorded. There was a significant relationship between RDS and the low level of vitamin D in the mother's serum. Mothers with low vitamin D had higher fetal pulmonary artery pulsatility index (PI) and peak systolic velocity (PSV) and lower acceleration time (AT) to ejection time (ET) ratio. Also, in neonates with RDS, pulmonary artery PI was higher, and PSV and the ratio of AT to ET were significantly lower than neonates without RDS. Neonates with lower one and 5-min apgar scores were born from mothers with lower vitamin D levels. Serum levels of vitamin D in pregnant mothers as well as fetal pulmonary artery Doppler indices are correlated to RDS. There is a significant relationship between the serum level of vitamin D in pregnant mothers and fetal pulmonary artery Doppler indices.

Predictive Value of Fetal Pulmonary Artery Doppler in Neonatal Respiratory Distress Syndrome

Predictive Value of Fetal Pulmonary Artery Doppler in Neonatal Respiratory Distress Syndrome

Assessment of fetal pulmonary artery Doppler indices in pregnant women with rheumatoid arthritis and ankylosing spondylitis.

To investigate fetal pulmonary artery Doppler parameters in pregnant women with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). This case-control study included 24 pregnant women diagnosed with 13 AS and 11 RA and 48 healthy pregnant women at 29-30 weeks of gestation. The demographic and clinical features were recorded, including disease type and duration, attacks during pregnancy, and medications. Pulmonary artery acceleration time (AT), ejection time (ET), and pulmonary artery acceleration time to ejection time (PATET) ratio were measured by manual trace with spectral Doppler ultrasound. A shorter pulmonary AT and lower PATET ratio were found in the case group (34.8 ± 2.3, p < 0.001, 0.18 ± 0.02, p < 0.001, respectively). When comparing the groups that had an attack during pregnancy and had not, there were no significant differences in the pulmonary artery indices. We also demonstrated a moderate correlation between maternal disease years and the PATET ratio (r = -0.562, p = 0.004). This is the first study to evaluate the effect of RA and AS on fetal pulmonary indices. Maternal inflammation might affect pulmonary development and circulation. Fetal pulmonary Doppler indices can be used to obtain further information about neonatal respiratory morbidities in rheumatological disorders.

Effect of maternal autoimmune diseases on fetal pulmonary artery Doppler indices: A case-control study.

To compare the fetal pulmonary artery Doppler indices of pregnant women with autoimmune diseases such as systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), and antiphospholipid syndrome (APS) with healthy pregnant women. Thirty-nine pregnancies were included in the case group, 19 of them SLE, 12 with SS, and eight with APS. The gestational age-matched 54 healthy pregnant women were included in the control group. Peak systolic velocity, time-averaged velocity, systolic/diastolic ratio, pulsatility index, resistance index, acceleration time (AT), ejection time (ET), and AT/ET ratio were obtained from pulmonary artery waveform by using spectral Doppler ultrasound. Significantly shorter AT and lower AT/ET ratio were detected in the case group (p=<.001, p=<.001, respectively). The shortening of AT and decreasing of the AT/ET ratio were more predominant in the APS group. However, there was no significant difference between the SLE, SS, and APS groups in fetal pulmonary artery Doppler indices. Also, a moderate correlation was found between maternal disease duration (years) and fetal pulmonary artery AT (r=-.516, p=.001) and AT/ET ratio (r=-.558, p=<.001). Fetal pulmonary artery Doppler indices may be affected in maternal autoimmune diseases. Further studies are needed to evaluate fetal pulmonary Doppler indices such as AT and AT/ET ratio to predict neonatal respiratory morbidity and lung maturation in pregnant women with SLE, SS, and APS.

Fetal main pulmonary artery Doppler and prediction of lung maturity

Background Respiratory distress syndrome (RDS) in newborns occurs owing to surfactant deficiency. Decrease in quantity and quality of surfactant in lungs results in diminished surfactant activity. It affects not only preterm neonates but also term ones. RDS is a serious condition as it can lead to many neonatal comorbidities and even death. Doppler ultrasound is a noninvasive tool used for assessment of fetal biometry, so Doppler of pulmonary artery can be used safely in assessment of fetal lung maturity. Aim The purpose of our study was to assess the significance of fetal pulmonary artery Doppler in predicting lung maturity. Patients and methods A total of 50 pregnant women participated in this study with gestational age ranging from 34 to 39 weeks who were referred to the Diagnostic Radiology Department at Tanta University Hospitals during the period between December 2019 and December 2021. Results From the 50 pregnant women included in this study, six fetuses developed RDS. The greatest correlation was found with acceleration time/ejection time (AT/ET) ratio and resistive index (RI) with high sensitivity and specificity (P=0.000 and P&lt;0.001, respectively). A cutoff value AT/ET less than 0.297 and RI more than 0.889 predicted RDS with sensitivity of 94.8 and 89.1%, respectively, and specificity of 83.5 and 78.2%, respectively. Conclusion Neonatal RDS can be predicted by pulmonary artery AT/ET ratio and RI with high sensitivity and specificity.

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

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.

Fetal pulmonary artery Doppler parameters in pregnancies complicated with intrahepatic cholestasis of pregnancy: a prospective case-control study

The primary aim of this study was to determine whether pulmonary artery acceleration time (AT) to ejection time (ET) ratio (PATET) was altered in fetuses of mothers with intrahepatic cholestasis of pregnancy (IHCP). The secondary aim was to investigate the association between fetal pulmonary artery Doppler parameters with neonatal outcomes in pregnancies complicated by IHCP. This prospective case control study was conducted in a tertiary perinatal-neonatal center. A total of 18 fetuses whose mothers’ pregnancies were complicated by IHCP were included as the study group and a total of 37 fetuses of mothers with healthy pregnancies were selected as controls. Fetal pulmonary artery Doppler parameters (AT; ET; AT/ET ratio) were assessed and neonatal outcomes were evaluated. Mean pulmonary artery AT, ET and PATET were significantly different between the groups (p=0.001, p=0.024 and p=0.003, respectively). The mean PATET value in the IHCP group was 0.217±0.029 while in the control group it was 0.180±0.020. While PATET values were correlated with gestational age at birth, respiratory distress and need for neonatal intensive care admission were not correlated with PATET. Higher values of PATET may be a useful biomarker of fetal lung damage, secondary to IHCP.

Comparison between Amniotic Fluid Lamellar Body Count and Fetal Pulmonary Artery Doppler Indices in Predicting Fetal Lung Maturity in Cases of PPROM

Comparison between Amniotic Fluid Lamellar Body Count and Fetal Pulmonary Artery Doppler Indices in Predicting Fetal Lung Maturity in Cases of PPROM

Acceleration time to Ejection time ratio in fetal pulmonary artery system can predict neonatal respiratory disorders in gestational diabetic mellitus women

Few researches studied fetal pulmonary pulse wave doppler and the clinical end point disorders in gestational diabetic mellitus (GDM) cohort. To investigate fetal pulmonary artery acceleration time to ejection time ratio (PATET) in the prediction of neonatal respiratory disorders (NRD). 238 pregnant women diagnosed with GDM who attended our hospital between February 2018 and March 2020 were retrospectively included. Fetal pulmonary artery Doppler wave measurements were recorded, including main, left and right pulmonary artery blood flow, and left and right peripheral pulmonary artery blood flow. Acceleration time (At)/ejection time (Et) were calculated. 183 GDM pregnant women and neonates were divided into NRD(+)(n = 42) and NRD(-) group (n = 141). 16 cases were neonatal pneumonia (NP) within 28 days after birth in NRD(+) group. The area under curve (AUC) of left peripheral pulmonary artery acceleration time to ejection time (LPPATET) was 0.967 (95% CI: 0.927∼1.000, P < 0.001) and the AUC of right peripheral pulmonary artery acceleration time to ejection time (RPPATET) was 0.967 (95% CI: 0.927∼1.000, P < 0.001), indicating that LPPATET and RPPATET are both predictors for NRD. The results of interobserver variabilty and intraobserver variability showed a good consistency. The At/Et of fetal peripheral pulmonary artery (PPA) in GDM women may be predictors for NRD, and the indicator can provide assistance in clinical management of diabetes pregnant patients.

The Relationship between Pulmonary Artery Doppler and Non-Doppler Sonographic Parameters in the Fetal Lung Maturity According to Gestational Age

Background: The evaluation of ultrasonic parameters of the lungs, especially the pulmonary arteries for gestational age, is still the first assessment of fetal lung maturity. We aimed to assess the relationship between pulmonary artery Doppler and non-Doppler sonographic parameters in the lung maturation of a fetus according to gestational age. Methods: This cross-sectional study was performed on pregnant women at different gestational ages that were indicated for Doppler ultrasonography as an indication for assessing fetal lung maturity. The correlation between non-Doppler sonographic indices and fetal pulmonary artery Doppler indices was evaluated. Results: Epiphyseal ossification centers, BPD, pulmonary echogenicity and free particles immersed in amniotic fluid were significantly higher in the group with a gestational age of 34 to 40 weeks than the group with a gestational age of 25 to 32 weeks. There was a significant difference in the mean of peak systolic velocity (PSV), ejection time (ET), acceleration time (AT) as well as acceleration time/ejection time (AT/ET) ratio between the two groups with a gestational age of 34 to 40 weeks and the group with a gestational age of 25 to 32 weeks. PSV, AT, ET, and AT/ET ration could predict fetal lung maturity with high sensitivity and specificity. Conclusion: With increasing gestational age, an increase in PSV, increase in AT, decrease in ET, and increase in AT/ ET indices are expected. In this regard, PSA, AT, ET, and AT/ET values are able to predict neonatal lung maturity with acceptable sensitivity and specificity.

Fetal pulmonary artery doppler parameters in pregnancies complicated with intrahepatic cholestasis of pregnancy: a prospective case-control study.

The primary aim of this study was to determine whether PATET was altered in the fetuses whose mothers were complicated by intrahepatic cholestasis of pregnancy (IHCP). The secondary aim was to investigate the association between fetal pulmonary artery Doppler parameters with neonatal outcomes in pregnancies complicated by IHCP. This prospective case control study was conducted in a tertiary perinatal- neonatal center. A total of 18 fetuses whose mothers were complicated by IHCP were set as the study group and a total of 37 fetuses whose mothers were healthy were selected as the control group. Fetal pulmonary artery Doppler parameters (acceleration time -AT; ejection time -ET; AT/ET ratio) were assessed and neonatal outcomes were evaluated. Mean pulmonary artery AT, ET, PATET were statistically significant different between the groups (p=0,001; p=0,024 and p=0,003, respectively). The mean PATET value in the IHCP group was 0,217 ± 0,029 while in the control group it was 0,180 ± 0,020 (p=0,003). While PATET values were correlated with gestational age at birth, respiratory distress and NICU admission were not correlated with PATET. Higher values of PATET may be helpful to understand fetal lung damage secondary to IHCP. of PATET may be helpful to understand fetal lung damage secondary to IHCP.

Correlation between Progesterone as a Treatment of Preterm Labor and Changes in Fetal Pulmonary Artery Doppler

Correlation between Progesterone as a Treatment of Preterm Labor and Changes in Fetal Pulmonary Artery Doppler

The Role of Fetal Pulmonary Artery Doppler in Prediction of Fetal Lung Maturity

The Role of Fetal Pulmonary Artery Doppler in Prediction of Fetal Lung Maturity

Role of Fetal Pulmonary Artery Doppler in predicting risk of neonatal respiratory distress syndrome

INTRODUCTION- To determine the optimal time to safely deliver a baby prematurely due to various clinical situations, it is crucial to accurately assess fetal lung maturity. Sonography which is a non-invasive technique for evaluating fetal lung maturity can be useful in predicting risk for developing neonatal respiratory distress as compared to amniocentesis which is an invasive procedure with associated risks. AIM - Purpose of this study was to determine if fetal main pulmonary artery doppler can play a role in predicting the risk of developing respiratory distress syndrome in neonates. MATERIAL AND METHODS – The participants in this prospective cross-sectional study were 75 pregnant women with gestational ages ranging from 34weeks to 36 weeks +6 days. Ultrasound doppler examination was conducted and peak systolic velocity (PSV), Systolic /Diastolic ratio, pulsatility index, resistive index were measured and acceleration time/ejection time ratio was calculated for the fetal main pulmonary artery. Diagnostic accuracy of these values was tested for predicting neonatal respiratory distress. RESULT - Of the 75 fetuses included in the study, 15 (20%) showed some signs of neonatal respiratory distress syndrome (RDS). The Acceleration time/Ejection time (AT/ET) ratio in fetal pulmonary artery correlated significantly with development of respiratory distress syndrome in neonates (P=0.001). Fetuses with respiratory distress syndrome had higher Pulsatility Index and Resistive Index values, while their AT/ET ratio was low. AT/ET was found to predict respiratory distress development with a cutoff value of 0.30 (sensitivity: 98.3 percent; specificity: 86.67 percent). Pulsatility Index and Resistive Index displayed lower sensitivity and specificity than AT/ET ratio. CONCLUSION- The fetal main pulmonary artery AT/ET ratio has a high sensitivity and specificity for predicting the development of neonatal respiratory distress syndrome. Thus, we recommend that a fetus with an AT/ET ratio of &lt;0.30 be delivered in a facility with good neonatal care.

Fetal Pulmonary Artery Doppler as Non Invasive Predictor for Lung Maturity in Diabetic Patients: Does it Help?

Fetal Pulmonary Artery Doppler as Non Invasive Predictor for Lung Maturity in Diabetic Patients: Does it Help?

Prediction of Fetal Lung Maturity by Fetal Pulmonary Artery Doppler in Cases of Severe Pre-Eclampsia

Background: Severe pre-eclampsia occurring remote from the term is a decision-making dilemma for the obstetrician, the general recommendation is that women with severe pre-eclampsia should be delivered to avoid maternal complications; others recommend prolonging pregnancy in most cases of severely premature pre-eclamptic gestation until the development of fetal lung maturity, development of fetal or maternal distress, or achievement of gestational age of 34 to 36-week of gestation. The cut-off level of pulmonary artery acceleration time to ejection time ratio [PAT/ET] that determines fetal lung maturity in cases of severe pre-eclampsia [PE] is not determined yet.Aim of the work: To study the Doppler indices of the main fetal pulmonary artery and their role in predicting respiratory distress syndrome [RDS] in severe pre-eclampsia.Patients and Methods: A prospective longitudinal cohort research was designed in which 102 pregnant women with PE were chosen and fetal pulmonary artery flow velocity data were acquired by Doppler ultrasound and linked with the development of neonatal RDS.Results: The AT/ET ratio in the fetal pulmonary artery velocity waveform was found to be directly related to the development of newborn RDS. A cut-off value of 0.3 resulted in a sensitivity of 71.4%, specificity of 79.7%, and total accuracy of 77.5%.Conclusion: A high AT/ET ratio in the fetal pulmonary artery is related to the future development of RDS in neonates of mothers with severe pre-eclampsia, implying that fetal pulmonary artery Doppler ultrasound may be a valuable tool in the identification of fetal lung maturity in situations of severe pre-eclampsia.

Fetal pulmonary artery Doppler evaluation in pregnant women after recovery from COVID‐19

ObjectiveTo evaluate fetal lung development using pulmonary artery Doppler in pregnant women who had recovered from COVID‐19.MethodsThe prospective case–control study included 41 pregnant women who had recovered from COVID‐19 and 43 healthy pregnant women (control group). All the women in the study group had been diagnosed with COVID‐19 and had completed a quarantine period.ResultsThe demographic data of patients were similar in the groups (P > 0.05). Main pulmonary artery peak systolic velocity was higher and pulsatility indices were lower in pregnant women who recovered from COVID‐19 compared to the controls (P < 0.001, P = 0.001). Acceleration time, ejection time, and acceleration/ejection time ratio (PATET) of the fetal MPA Doppler were significantly decreased in pregnant women who recovered from COVID‐19 (P < 0.001, P = 0.036, and P = 0.002, respectively). The patients who had recovered from COVID‐19 were divided into two groups: those treated with expectant management and those treated in hospital. The pulmonary artery acceleration time and PATET ratio were significantly lower in the group treated in the hospital (P = 0.023 and P = 0.045, respectively).ConclusionDetailed Doppler evaluations of the pulmonary artery may help in evaluating the fetal adverse effects of COVID‐19 disease.

Effects of SARS-COV-2 infection on fetal pulmonary artery Doppler parameters.

PurposeTo determine the effect of SARS‐CoV‐2 infection on the fetal pulmonary system using the acceleration time (AT), ejection time (ET), and acceleration/ejection time ratio (PATET) of the fetal main pulmonary artery Doppler waveform.MethodsWe prospectively studied pregnant women attending our hospital with confirmed SARS‐CoV‐2 infection by RT‐PCR test and an age‐matched control group who admitted for routine prenatal care. An ultrasound examination that included measurements of the AT, ET, and AT/ET ratio (PATET) were performed and the results were compared.ResultsFifty‐five SARS‐CoV‐2‐infected and 93 control group pregnant women were included in this study. AT found higher in the COVID‐19 positive group when compared with controls. When the ET and PATET parameters were compared, no differences were detected between the groups. Eleven neonates had Neonatal Intensive Care Unit (NICU) requirement in the COVID‐19 positive group while there were none in the control group. All fetal pulmonary artery Doppler values were decreased in NICU admitted fetuses. The mean gestational week of this group was lower than non‐NICU COVID‐19 positive group and the control group.ConclusionCOVID‐19 infection increases fetal pulmonary blood flow, which appears high AT values on Doppler parameters. NICU admission only occurred in the COVID‐19 group and their Doppler values were found significantly lower than non‐NICU COVID‐19 group. The clinical significance of this result must be evaluated with further studies.