Büke Barış, Akkaya Hatice
Department of Obstetrics and Gynecology, Kayseri Training and Research Hospital, Kayseri, Turkey.
J Perinat Med. 2018 Feb 23;46(2):219-224. doi: 10.1515/jpm-2016-0380.
To investigate whether fetal pulmonary artery acceleration to ejection time (PATET) ratio can predict or rule out subsequent diagnosis of transient tachypnea of the newborn (TTN).
This prospective cohort study included 105 pregnant women in labor, who met the inclusion criteria. Eighteen of these women were removed from the study cohort, because of an inability to acquire sufficient Doppler waveforms and a longer duration of deliveries. According to subsequent diagnosis of TTN in the neonate, the two groups were constituted, TTN+ and TTN-.
There were no statistically significant differences between the groups regarding maternal obstetric and demographic features. The neonatal intensive care unit (NICU) submission rate was significantly higher in the TTN+ group (100%, 17%, P<0.0001, respectively). Regarding the fetal pulmonary artery Doppler findings, PATET ratio in the TTN+ group was significantly lower than the TTN- group (0.307 vs. 0.389, P<0.0001, respectively). The PATET ratio and diagnosis of TTN were inversely correlated (r=-0.41, P<0.001), even if adjusted for birth weight, gestational age and fetal gender (r=0.42, P=0.0021). The cut-off value of 0.319 provided 82.7% specificity, 83.3% sensitivity, 96% negative predictive value and 41.6% positive predictive value. Additionally intraobserver ICC for PATET was found to be 0.86.
The fetal PATET ratio seems to serve as a promising tool to rule out subsequent diagnosis of TTN.
探讨胎儿肺动脉加速时间与射血时间（PATET）比值能否预测或排除新生儿暂时性呼吸急促（TTN）的后续诊断。
这项前瞻性队列研究纳入了105名符合纳入标准的临产孕妇。其中18名妇女因无法获取足够的多普勒波形和分娩时间较长而被排除在研究队列之外。根据新生儿TTN的后续诊断，分为TTN+组和TTN-组。
两组在产妇产科和人口统计学特征方面无统计学显著差异。TTN+组新生儿重症监护病房（NICU）收治率显著更高（分别为100%和17%，P<0.0001）。关于胎儿肺动脉多普勒检查结果，TTN+组的PATET比值显著低于TTN-组（分别为0.307和0.389，P<0.0001）。PATET比值与TTN诊断呈负相关（r=-0.41，P<0.001），即使在调整出生体重、胎龄和胎儿性别后也是如此（r=0.42，P=0.0021）。截断值0.319的特异性为82.7%，敏感性为83.3%，阴性预测值为96%，阳性预测值为41.6%。此外，观察者间PATET的ICC为0.86。
胎儿PATET比值似乎是排除TTN后续诊断的一种有前景的工具。
