Fetal pulmonary artery acceleration/ejection time prognostic accuracy for respiratory complications in preterm prelabor rupture of membranes

Duncan, Jose R.; Tobiasz, Ana; Dorsett, Katherine M; Aziz, Michael M.; Thompson, RE; Bursac, Zoran; Talati, Ajay J.; Mari, Giancarlo; Schenone, Mauro

doi:10.1080/14767058.2018.1536744

Cited by 21 publications

(15 citation statements)

References 18 publications

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“…Likewise, the study of Guan et al [11] on 43 preterm neonates reported that only pulmonary artery acceleration time [at] and At/Et ratio could predict neonatal RDS. The predictive capability of pulmonary artery At/Et ratio was also appreciated by the recent works of Büke et al [14] on 105 women and Duncan et al [17] on 95 preterm neonates. Interestingly and in support of our conclusions, the study of Azpurua et al [18] on 29 neonates documented an inverse relationship between the amniotic fluid lecithin/sphingomyelin ratio, a maturation marker of fetal-lung, and At/Et ratio in the fetal PA.…”

Section: Discussionmentioning

confidence: 81%

Relation Between Fetal Doppler Pulmonary Artery Indices and Neonatal Respiratory Distress Syndrome In Term Neonates

Alsheikh

ElSadek

Gebreel

2020

International Journal of Medical Arts

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Background: Neonatal respiratory distress syndrome (RDS) is a common and challenging neonatal morbidity.Reliable prediction of the condition can improve management. Fetal pulmonary artery (PA) Doppler indices were suggested for prediction. However, the findings of different studies are conflicting. Aim of the work:The present study aimed to assess the value of PA indices in the prediction of neonatal RDS in term babies. Subjects and methods:This prospective study included 120 women with singleton term pregnancy. Assessed Doppler indices for the main pulmonary artery included pulsatility index (PI), resistive index (RI), peak systolic velocity (PSV), and the At/Et ratio. Upon delivery, the newborn babies were examined for RDS signs (tachypnea, retractions, and/or nasal flaring).Results: Among the 120 delivered babies, there were 16 (13.3 %) with RDS. Comparison between neonates with RDS and neonates without showed significantly lower neonatal weight, higher pulmonary artery RI and PI, higher pulmonary artery PSV in neonates with RSD. Also, they had a significantly lower pulmonary artery at/et ratio when compared with normal babies. The pulmonary artery at/et ratio showed the best performance compared to other indices (sensitivity: 100.0 %, specificity: 50.0 %) at a cut-off (0.32). Conclusions:The present study documented reliable predictive value of PA hemodynamic parameters including RI, PI, PSV, and at/et ratio in predicting neonatal RDS in term babies.

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Section: Discussionmentioning

confidence: 81%

Relation Between Fetal Doppler Pulmonary Artery Indices and Neonatal Respiratory Distress Syndrome In Term Neonates

Alsheikh

ElSadek

Gebreel

2020

International Journal of Medical Arts

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“…PPROM is associated with a prenatal morbidity and mortality rate in more than 20%, and the outcomes are primarily dependent on the gestational age at delivery. The key for reducing the adverse effects of PPROM is to make a prompt diagnosis, admission and start antibiotic coverage (4) . The aim of the present study was to measure the incidence rate of PPROM among pregnant women attending Zagazig University Hospital, and to identify the risk factors associated with PROM and fetal/neonatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Incidence Rate, Risk Factors and Outcome of Premature Rupture of Membranes (PROM) at Zagazig University Hospitals

Maaboud

Nossair

Ali

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Premature rupture of membranes (PROM) is a common pregnancy complication and is associated with significant risks of fetal and neonatal morbidity and mortality. Objective: This study aimed to measure the incidence rate of preterm premature rupture of membranes (PPROM) among pregnant women attending Zagazig University Hospital, and to identify the risk factors associated with PROM and fetal/neonatal outcomes. Methods: This cross-sectional study was conducted at Zagazig University Hospitals. It included 69 women with PROM. The study was conducted from July 2019 to January 2020. All patients were subjected to detailed history taking, general examination and laboratory investigations. Results: There were 46 mother gave birth of healthy babies with good Apgar score (66.7%), 15 with babies needed O2 incubators (21.7%) and 8 with babies that were put on ventilators (11.6%). There were 68 mothers with no bad outcomes and 1 with chorioamnionitis. The risk factors of the cases showed that there were 15 with no risk factor (21.7%), 8 with previous PROM (11.6%), 6 with multi pregnancy (8.7%), 12 with antepartum (17.4%), 16 with infections (23.2%) and 12 with chronic diseases (17.4%). Conclusions: we concluded that younger, illiterate parturient women were found to be provoking factors to increased PPROM. Such hazards may affect both maternal and neonatal outcome such as infection, maternal distress, fetal distress, increase operative delivery, as well as need for neonatal intensive care unit care in more than 50% of the neonates.

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“…This phenomenon reflects the intimate relationship between pulmonary arterial pressure and pulmonary maturity, while providing an explanation for their inversely proportional relationship. The literature has consistently shown that fetal pulmonary maturity, traditionally assessed by amniotic fluid tests, such as surfactant/albumin ratio, can be predicted by Doppler analysis of pulmonary arterial flow, utilizing the AT/ET ratio, with high sensitivity and specificity, at a cut-off of 0.32 to 0.35, depending on the methodology utilized, owing to the progressive increase in AT toward the end of gestation [36][37][38][39][40] . Doppler assessment of MPAP has been proposed, utilizing AT as the dependent variable in the Dabestani equation, having been validated and shown to decrease towards the end of gestation, as well as to correlate inversely with variation of the AT/ET ratio [36][37][38][39][40] .…”

Section: Discussionmentioning

confidence: 99%

Improvement in fetal pulmonary hypertension and maturity after reversal of ductal constriction: prospective cohort study

Zielinsky

Magalhães²,

Zurita-Peralta³

et al. 2021

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?Fetal estimated mean pulmonary arterial pressure decreases and pulmonary vascular maturation increases after reversal of fetal ductus arteriosus constriction by reducing maternal intake of the causal agent (prostaglandin inhibitors), these effects being strongly correlated and independent of gestational age. What are the clinical implications of this work?The finding that fetal pulmonary vascular maturity and pulmonary hypertension improve when ductus arteriosus constriction is resolved by reducing maternal intake of prostaglandin inhibitors stresses the importance of adequate maternal guidance in late gestation in order to treat and prevent this potentially severe functional fetal disorder.

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Fetal pulmonary artery acceleration/ejection time prognostic accuracy for respiratory complications in preterm prelabor rupture of membranes

Cited by 21 publications

References 18 publications

Relation Between Fetal Doppler Pulmonary Artery Indices and Neonatal Respiratory Distress Syndrome In Term Neonates

Relation Between Fetal Doppler Pulmonary Artery Indices and Neonatal Respiratory Distress Syndrome In Term Neonates

Incidence Rate, Risk Factors and Outcome of Premature Rupture of Membranes (PROM) at Zagazig University Hospitals

Improvement in fetal pulmonary hypertension and maturity after reversal of ductal constriction: prospective cohort study

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