Aafreen Shama, Kumar Manisha, Nangia Sushma
Department of Obstetrics and Gynaecology, Lady Hardinge Medical College and Associate Hospitals, Shahid Bhagat Singh Marg, New Delhi, 110001 India.
Department of Neonatology, Lady Hardinge Medical College and Associate Hospitals, New Delhi, 110001 India.
J Obstet Gynaecol India. 2022 Aug;72(Suppl 1):198-203. doi: 10.1007/s13224-021-01592-w. Epub 2022 Mar 20.
This study aimed to compare the prenatal ultrasound parameters- fetal lung biometry and pulmonary artery Doppler in preterm newborns for prediction of respiratory distress (RD).
A prospective analytic study was conducted in Department of Obstetrics and Gynecology in collaboration with Department of Neonatalogy. Fetal ultrasound and Doppler parameters were evaluated in women predisposed to have preterm delivery at or before 34 weeks. The neonates were followed for occurrence of RD.
Out of 100 study population, neonates who developed RD were taken as cases ( = 36) and rest were grouped as controls ( = 64). The gestational age at delivery, mean birth weight and Apgar score were significantly less in cases than controls. All the fetal lung biometric parameters were significantly less in cases than controls ( value < 0.001). The fetal lung volume had highest sensitivity (72.22%) and negative predictive value (83%). The right lung area had highest specificity (89%) and positive predictive value (72%). Among the Doppler parameters, the At/Et ratio showed high degree of accuracy (68%). The sensitivity and specificity were 55.56% and 75%, respectively. The positive and negative predictive values were 72% and 60%, respectively.
Both fetal lung biometry and pulmonary artery Doppler offer an excellent noninvasive approach for assessment of fetal lung maturity, clinically assessed by RD. On comparison of all the ultrasound parameters, fetal lung volume and At/Et ratio showed highest degree of accuracy in prediction of RD.
本研究旨在比较早产新生儿的产前超声参数——胎儿肺测量和肺动脉多普勒,以预测呼吸窘迫(RD)。
在妇产科与新生儿科合作开展了一项前瞻性分析研究。对在34周及以前有早产倾向的孕妇进行胎儿超声和多普勒参数评估。对新生儿进行随访,观察是否发生RD。
在100名研究对象中,发生RD的新生儿作为病例组(n = 36),其余作为对照组(n = 64)。病例组的分娩孕周、平均出生体重和阿氏评分显著低于对照组。病例组所有胎儿肺测量参数均显著低于对照组(P值<0.001)。胎儿肺容积的敏感性最高(72.22%),阴性预测值最高(83%)。右肺面积的特异性最高(89%),阳性预测值最高(72%)。在多普勒参数中,At/Et比值显示出较高的准确性(68%)。敏感性和特异性分别为55.56%和75%。阳性预测值和阴性预测值分别为72%和60%。
胎儿肺测量和肺动脉多普勒均为评估胎儿肺成熟度提供了一种良好的非侵入性方法,临床上通过RD进行评估。比较所有超声参数,胎儿肺容积和At/Et比值在预测RD方面显示出最高的准确性。