Optimization of Prenatal Screening for Developmental Lung Anomalies

Abstract

Objective: to determine the list of ultrasound criteria for normal development of the fetal lung, the use of which will make it possible to identify lung malformations in the fetus effectively, as well as to predict the development of lung hypoplasia in the newborn. Material of the research. The fetuses of singleton pregnancy in 1570 female patients of Minsk during the gestation period of 20-37 weeks. Results. The minimum list of the ultrasound criteria for the features of the lung development, which should be used for screening ultrasound examinations of pregnant women aimed at the detection of congenital lung malformations of the fetus, has been determined. The work indicates cases which require additional measurement of the lung volume of the fetus, the most optimal method for which is to use the VOCAL software package during three-dimensional sonography or direct measurement by MRI. The measurement data for the percentile values of the fetal lung volume taking into account the regional biometric features, as well as the percentile measurement data for the quantity of amniotic fluid have been determined. Conclusion. The minimum list of the ultrasound criteria for adequate lung development, the use of which during the screening ultrasound examinations of pregnant women will make it possible to detect congenital lung malformations of the fetus with high sensitivity, includes such characteristics as parenchyma homogeneity, diaphragm position, fluid in the pleural cavity, and the presence of fluid movement through the airways. The prenatal prediction of the development of respiratory distress syndrome in newborns requires direct measurement of the lung volume by means of the volumetric calculation program of three-dimensional sonography or MRI, followed by the assessment of the results using the tables of the regional percentile values, developed by the authors. Also, in cases of oligohydramnios, to make such a prediction, it is necessary to assess the quantity of amniotic fluid using the tables of the regional percentile values, developed by the authors.