Fetal MRI for prediction of neonatal mortality following preterm premature rupture of the fetal membranes.

BACKGROUND

Lung MRI volumetrics may be valuable for fetal assessment following early preterm premature rupture of the foetal membranes (pPROM).

OBJECTIVE

To evaluate the predictive value of MRI lung volumetrics after pPROM.

MATERIALS AND METHODS

Retrospective cohort study of 40 fetuses after pPROM in a large, tertiary, perinatal referral center. Fetuses underwent MRI lung volumetrics. Estimated lung volume was expressed as percentage of expected lung volume (our own normal references). Primary outcome was neonatal mortality due to respiratory distress before discharge from hospital.

RESULTS

Gestational age range was 16-27 weeks. Estimated-to-expected lung volume was 73% in non-survivors and 102% in survivors (P < 0.05). There were no survivors with a lung volume less than 60% of expected. By logistic regression, mortality could be predicted with a sensitivity of 80%, specificity of 86% and accuracy of 85%.

CONCLUSION

Fetal MR lung volumetrics may be useful for predicting mortality due to respiratory distress in children with early gestational pPROM.