Laban Mohamed, Mansour Ghada M, El-Kotb Ahmed, Hassanin Alaa, Laban Zina, Saleh Abdelrahman
a Department of Obstetrics & Gynaecology , Ain Shams University , Cairo , Egypt.
b Department of Statistics , Columbia University in the City of New York , New York , NY , USA.
J Matern Fetal Neonatal Med. 2019 Feb;32(4):626-632. doi: 10.1080/14767058.2017.1387891. Epub 2017 Oct 12.
The objective of this study is to estimate optimal cut-off values for mean fetal lung volume (FLV) and pulmonary artery resistance index (PA-RI) as non-invasive measures to predict neonatal respiratory distress syndrome (RDS) in preterm fetuses.
A prospective study conducted at Ain Shams University Maternity Hospital, Egypt from May 2015 to July 2017: 80 eligible women diagnosed with preterm labor were recruited at 32-36 weeks' gestation. Before delivery, three-dimensional ultrasound was used to estimate FLV using virtual organ computer-aided analysis (VOCAL), while PA-RI was measured by Doppler ultrasonography.
A total of 80 women were examined. Thirty-seven (46%) of the newborns developed neonatal RDS. FLV was significantly lower in neonates who developed RDS (p = .04), whereas PARI was significantly higher in those who did not (p = .02). Cut-off values of FLV ≤27.2 cm and PARI ≥0.77 predicted the subsequent development of RDS. Combining both cut-offs generated a more sensitive and specific methodical approach for the prediction of RDS (sensitivity 100%, specificity 88.5%).
Measurement of FLV or PA-RI can predict RDS in preterm fetuses. Combined use of both measures bolstered their predictive significance.
本研究的目的是估计平均胎儿肺容积（FLV）和肺动脉阻力指数（PA-RI）的最佳截断值，作为预测早产胎儿新生儿呼吸窘迫综合征（RDS）的非侵入性指标。
2015年5月至2017年7月在埃及艾因夏姆斯大学妇产医院进行的一项前瞻性研究：招募了80名在妊娠32 - 36周被诊断为早产的合格女性。分娩前，使用三维超声通过虚拟器官计算机辅助分析（VOCAL）估计FLV，同时通过多普勒超声测量PA-RI。
共检查了80名女性。37名（46%）新生儿发生了新生儿RDS。发生RDS的新生儿FLV显著更低（p = 0.04），而未发生RDS的新生儿PA-RI显著更高（p = 0.02）。FLV≤27.2 cm和PA-RI≥0.77的截断值可预测RDS的后续发生。将两个截断值结合可产生一种更敏感和特异的预测RDS的方法（敏感性100%，特异性88.5%）。
测量FLV或PA-RI可预测早产胎儿的RDS。两者联合使用增强了它们的预测意义。
