Role of 3D Ultrasound for Assessment of Fetal Lungs

Authors

The Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University

Abstract

Abstract Background: Fetal lung maturity is vital to the survival rate of neonates, and is a determinant of extra uterine life. Neonatal respiratory distress syndrome and associated com-plications account for 28% of neonatal deaths. Although the wide use of glucocorticoids has decreased the incidence of Neonatal respiratory distress syndrome, approximately 10% of neonates still develop the syndrome. Aim of Study: To study the role of 3D ultrasound for assessment of fetal lungs. Patients and Methods: A total of 50 pregnant women 34- 40 weeks gestation after a complication-free normal course of pregnancy were enrolled in the study. They were classified into 2 groups as follows: 1. Group A: (n=25) women 34-37 weeks gestation. 2. Group B: (n=25) women 37-40 weeks gestation. All the included women were subjected to: Full history taken. Ultrasound examination to confirm GA, assess Amniotic Fluid Index (AFI) and to exclude fetal anomalies. 3D ultrasound was carried out to asses fetal lung volume. After child birth, APGAR score at (1, 5 and 10min) was assessed together with occurrence of RDS and the further need for neonatal ICU admission and respiratory support measurements. Results: The mean value of fetal lung volume was signif-icantly increased in term group (52.96±4.91) when compared to preterm group (44.08±6.43) (p=0.001). In the term group the percentage of neonates which did not experience Respira-tory Distress Syndrome (RDS) was 60% compared to 24% in the preterm group (p=0.001). In the preterm group the per-centage of admitted neonates in the Intensive Care Unit (ICU) was statistically increased (68%) when compared to the term group (54%) (p=0.047). The percentage of women in the preterm group received prenatal steroids 36% was statistically higher than those in the term group 24% (p=0.047). In the present study, fetal lung volume was positively correlating with gestational age (r=0.531; p-value=0.001). In the present study, in the preterm group RDS was negatively correlated with steroids (r=–0.304; p-value=0.032). Conclusion: Ultrasound indices, including fetal lung volume may serve as useful alternatives to amniotic fluid phospholipids in analyzing fetal lung maturity. Fetal lung volume might be an accurate non-invasive predictor for the occurrence of neonatal RDS among preterm fetuses in whom the risk of RDS development deserve fetal lung maturity testing.

Keywords