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联合测量胎儿肺容积和肺动脉阻力指数对预测早产胎儿的新生儿呼吸窘迫综合征更准确:一项初步研究。

Combined measurement of fetal lung volume and pulmonary artery resistance index is more accurate for prediction of neonatal respiratory distress syndrome in preterm fetuses: a pilot study.

作者信息

Laban Mohamed, Mansour Ghada M, El-Kotb Ahmed, Hassanin Alaa, Laban Zina, Saleh Abdelrahman

机构信息

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.

出版信息

J Matern Fetal Neonatal Med. 2019 Feb;32(4):626-632. doi: 10.1080/14767058.2017.1387891. Epub 2017 Oct 12.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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%).

CONCLUSION

Measurement of FLV or PA-RI can predict RDS in preterm fetuses. Combined use of both measures bolstered their predictive significance.

摘要

目的

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。

方法

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。

结果

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%)。

结论

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。

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