Prenatal Ultrasound Markers: A Comparative Study for Prediction of Respiratory Distress in Early Preterm Newborns

产前超声标志物:预测早产儿呼吸窘迫的比较研究

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Abstract

PURPOSE OF STUDY: 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). METHODS: 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. RESULT: Out of 100 study population, neonates who developed RD were taken as cases (n = 36) and rest were grouped as controls (n = 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 (p 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. CONCLUSIONS: 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.

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