Diagnostic and Interventional Radiology Department, Faculty of Medicine, Ain Shams University, 38 Ramsis Street, Abassia, Nasr City, Cairo, 11765, Egypt.
Technology of Radiology and Medical imaging program, Faculty of Applied Health Sciences Technology, Galala University, Suez, Egypt.
J Ultrasound. 2023 Jun;26(2):525-533. doi: 10.1007/s40477-023-00780-w. Epub 2023 Apr 20.
The aim of this study is to highlight the predictive role of perinatal fetal main pulmonary artery (MPA) Doppler measurements in neonatal respiratory distress syndrome development. Respiratory distress syndrome (RDS) is one of the lead causes of neonatal respiratory distress as well as neonatal death. Thus, it seems logic to evaluate fetal lung maturity before labour.
The study is a prospective cohort study performed in tertiary hospital over a period of one-year duration. 70 pregnant ladies between 34 and 38 weeks of gestation were referred for fetal echo, when pregnancy was considered a high risk. A trained radiologist using dedicated ultrasound machine with updated obstetric and fetal echo software performed the fetal echo. Doppler mode and curvilinear probe of 5.7 MHz transducer. Pediatric neonatologist observed the neonatal outcome post-natally.
A total of 70 pregnant patients with risk factors underwent fetal echo, 26/70 (37.1%) were diagnosed with RDS conforming to the neonatal criteria. The mean acceleration time/ejection time ratio (At/Et ratio) of the fetal pulmonary artery was significantly reduced in fetuses that subsequently developed RDS than those without RDS. Contrarily, the mean pulsatility index (PI), resistance index (RI), and peak systolic velocity (PSV) of the fetal pulmonary artery were significantly high in fetuses who later developed RDS than in those who did not.
Fetal MPA Doppler measurements have a major role in anticipating the development of neonatal RDS in preterm and early term neonates.
本研究旨在强调围产胎儿主肺动脉（MPA）多普勒测量在新生儿呼吸窘迫综合征发展中的预测作用。呼吸窘迫综合征（RDS）是新生儿呼吸窘迫和新生儿死亡的主要原因之一。因此，在分娩前评估胎儿肺成熟度似乎是合理的。
这是一项在三级医院进行的为期一年的前瞻性队列研究。当妊娠被认为是高危时，70 名 34 至 38 孕周的孕妇被转介进行胎儿超声检查。一名经过培训的放射科医生使用带有最新产科和胎儿超声软件的专用超声机进行胎儿超声检查。多普勒模式和 5.7MHz 换能器的曲线探头。儿科新生儿科医生在产后观察新生儿的结局。
共有 70 名有危险因素的孕妇接受了胎儿超声检查，其中 26/70（37.1%）被诊断为符合新生儿标准的 RDS。随后发生 RDS 的胎儿肺动脉的加速时间/射血时间比（At/Et 比）明显低于未发生 RDS 的胎儿。相反，随后发生 RDS 的胎儿肺动脉的平均搏动指数（PI）、阻力指数（RI）和收缩期峰值速度（PSV）明显高于未发生 RDS 的胎儿。
胎儿 MPA 多普勒测量在预测早产儿和早期早产儿新生儿 RDS 的发生方面具有重要作用。
