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

Objective: Studying the correlation of different lung parameters, using three dimensional ultrasound (3D US) with fetal lung maturity (FLM) to predict the development of neonatal respiratory distress syndrome (RDS). Methods: Three dimensional ultrasound was done to record the fetal lung volume (FLV), Fetal lung to liver intensity ratio (FLLIR) & the main pulmonary artery (MPA) blood flow parameters; pulsatility index (PI), resistive index (RI) and acceleration time -to- ejection time ratio (At/Et), to 218 women between 32 to 40 weeks gestational age within 24 h from labor. Results: Of 218 fetuses examined, final analysis was done for 143 fetuses. Thirty eight (26.5%) were diagnosed with RDS. The MPA PI and RI were significantly higher in fetuses diagnosed with RDS compared with those without (2.51 ± 0.33 and 0.90 ± 0.03 cm/s versus 1.96 ± 0.20 and 0.84 ± 0.01 cm/s; p value < 0.001 and <0.001 respectively). MPA At/Et was significantly lower (0.24 ± 0.04 vs 0.35 ± 0.04; p value < 0.001). FLLIR was significantly lower (1.04 ± 0.07 vs 1.18 ± 0.11; p value < 0.001), and the mean FLV which was significantly smaller (28.23 ± 5.63, vs 38.87 ± 4.68 cm3; p value < 0.001). Conclusion: Main pulmonary artery (PI, RI, At/Et ratio), FLIIR, and mean FLV can be used as reliable predictors of neonatal RDS. Advances in knowledge: 3D ultrasound VOCAL technique, ultrasound tissue histogram and pulmonary artery Doppler are reliable tools for prenatal prediction of fetal lung maturity.

Download Full-text

363: A non-invasive method to predict fetal lung maturity using fetal pulmonary artery Doppler wave acceleration time/ejection time ratio

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2011.10.381 ◽

2012 ◽

Vol 206 (1) ◽

pp. S170

Author(s):

Mauro Schenone ◽

Jacques Samson ◽

Anju Suhag ◽

Laura Jenkins ◽

Giancarlo Mari

Keyword(s):

Pulmonary Artery ◽

Fetal Lung ◽

Ejection Time ◽

Acceleration Time ◽

Fetal Lung Maturity ◽

Non Invasive ◽

Time Ratio ◽

Invasive Method ◽

Lung Maturity

Download Full-text

Improved thin-layer chromatography of disaturated phosphatidylcholine in amniotic fluid.

Clinical Chemistry ◽

10.1093/clinchem/27.2.239 ◽

1981 ◽

Vol 27 (2) ◽

pp. 239-242 ◽

Cited By ~ 15

Author(s):

M Y Tsai ◽

M Cain ◽

M W Josephson

Keyword(s):

Respiratory Distress ◽

Thin Layer ◽

Amniotic Fluid ◽

Thin Layer Chromatography ◽

Fetal Lung ◽

Dipalmitoyl Phosphatidylcholine ◽

Fetal Lung Maturity ◽

Coefficients Of Variation ◽

Layer Chromatography ◽

Lung Maturity

Abstract We describe an indirect test of fetal lung maturity: the quantitation of disaturated phosphatidylcholine in amniotic fluid. The lipids in samples of amniotic fluid from 172 patients were reacted with osmium tetroxide, and disaturated phosphatidylcholine was then isolated by thin-layer chromatography. Interfering substances were retained by a pre-adsorbent layer. The charred disaturated phosphatidylcholine, quantitated by densitometry, was compared to standard dipalmitoyl phosphatidylcholine. Both within-run and between-run coefficients of variation were about 10%. Blood and meconium do not interfere. Six infants developed respiratory distress when disaturated phosphatidylcholine concentrations of amniotic fluid drawn within 72 h of delivery were less than 5.5 mg/L. A concurrently determined lecithin/sphingomyelin ratio falsely predicted lung maturity in one of these. In seven other samples for which lecithin/sphingomyelin ratios suggested lung immaturity but disaturated phosphatidyl-choline predicted maturity, none of the infants developed respiratory distress. In normal pregnancies, measurement of disaturated phosphatidylcholine in amniotic fluid appears to be a better predictor of fetal lung maturity than is measurement of the lecithin/sphingomyelin ratio. Further studies are needed to determine if this analysis is a better predictor in diabetic pregnancies.

Download Full-text