OP08.01: Prenatal prediction of fetal lung maturity using pulmonary artery Doppler and 3D ultrasound

The aim of the study was to investigate whether fetal pulmonary artery Doppler indices, fetal lung volume FLV and fetal lung liver intensity ratio FLLIR can predict the development of neonatal RDS and to develop reference cut-off values to be used to predict neonatal RDS. Patients included were admitted for delivery, had an uncomplicated singleton pregnancy and were delivered within 24 hours of the ultrasound exam. Pulmonary artery Doppler was measured using Pulsed Doppler at the pulmonary artery stem. Mean pulmonary MPA PI, RI and acceleration time-to-ejection time At/eT ratios were calculated. FLV was calculated using the VOCAL software. FLLIR was calculated with the histogram function. RDS was diagnosed postnatally by typical clinical signs, X-ray findings and ultrasound features. Final analysis included 143 fetuses, of which 38 (26.5%) were diagnosed with RDS. The MPA PI and RI were significantly higher in fetuses with RDS compared to those with no RDS (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 versus 0.35 ± 0.04; p-value < 0.001). Mean FLV was significantly smaller (28.23 ± 5.63 versus 38.87 ± 4.68 cm3; p-value < 0.001). FLLIR was significantly lower in fetuses with RDS compared to no RDS (1.04 ± 0.07 versus 1.18 ± 0.11; p-value < 0.001), The best cut-off of the various parameters for prediction of RDS was; 2.33 cm/s for MPA PI (AUC = 0.96; p < 0.001), diagnostic accuracy; 94.4 %, 0.89 cm/s for MPA RI (AUC = 0.94; p < 0.001), diagnostic accuracy ;88.1%,0.30 for MPA At/Et ratio (AUC = 0.96; p < 0.001), diagnostic accuracy; 94.4%,1.110 for FLLIR (AUC = 0.96; p < 0.001) diagnostic accuracy ;93.7%, 35.75 cm3 for mean FLV (AUC = 0.89; p < 0.001), diagnostic accuracy; 80.4% MPA PI, RI and At/Et, together with mean FLV and FLLIR can be used as noninvasive accurate methods for prediction of neonatal RDS and fetal lung maturity. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.