Postmortem Validation of Imaging-Derived Formulas for Prediction of Fetal Lung Volume

Paepe, Monique E. De; Carr, Stephen R.; Cassese, John A.

doi:10.1159/000071980

Cited by 7 publications

(9 citation statements)

References 13 publications

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“…In the material under examination, we indicated the proportionate volumetric growth of the two lungs, in keeping with some authors [1, 6, 18, 22, 26, 31], who found a constant linear regression between left and right pulmonary volumes throughout pregnancy. The left-to-right lung volume ratio was stable throughout the analyzed period, and averaged 0.823 ± 0.066.…”

Section: Discussionsupporting

confidence: 88%

“…The right, left and total pulmonary volumes, obtained in this study may serve as a useful reference to anatomists dealing with developmental growth patterns in the fetus. Of note, since formalin immersion little influences lung volumes in the sealed thoracic cavity [1, 16, 30], the results obtained in this study can directly be adapted in vivo to the fetus. Both prenatal ultrasound and MR imaging have been proved to enable the diagnosis or exclusion of pulmonary hypoplasia, in which our quantitative data, as relevant fetal age-specific references for pulmonary volumes may be reliably helpful.…”

Section: Discussionmentioning

confidence: 99%

“…The prenatal assessment of lung volume is indispensable in determining survival in both preterm infants and newborns affected by pulmonary hypoplasia [1], due to renal malformations, oligohydramnios, fetal hydrops, skeletal dysplasias, congenital diaphragmatic hernia, intrathoracic masses, pulmonary malformations (congenital adenomatoid malformation, bronchopulmonary sequestration), and fetal akinesia [2–9]. The only two methods that enable clinicians to reliably measure fetal lung volume are three-dimensional ultrasound and MRI.…”

Section: Introductionmentioning

confidence: 99%

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Volumetric growth of the lungs in human fetuses: an anatomical, hydrostatic and statistical study

et al. 2014

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PurposeThe prenatal assessment of lung volume is becoming increasingly important in determining survival in both preterm infants and newborns affected by pulmonary hypoplasia. This study aimed to examine the lung volumes in the human fetus at varying gestational ages.Materials and methodsUsing anatomical, hydrostatic (water displacement according to Archimedes’ patent) and statistical methods (one-way ANOVA test for paired data and post-hoc Bonferroni test, Kolmogorov–Smirnov test, Levene’s test, Student’s t test, regression analysis), volumes of the right and left lungs were measured in 67 human fetuses of both sexes (35 males, 32 females) aged 16–25 weeks, derived from spontaneous abortions and stillbirths.ResultsNo male–female differences concerning the right and left pulmonary volumes were found. The mean volume of the right lung increased from 1.43 ± 0.25 to 8.45 ± 2.66 cm3, according to the cubic function y = –1.592 + 0.0007 × age3 ± 0.851 (R2 = 0.84). The volumetric growth of the left lung, from 1.24 ± 0.22 to 6.78 ± 3.03 cm3, followed the cubic model y = –1.110 + 0.0005 × age3 ± 0.794 (R2 = 0.78). The total pulmonary volume increased from 2.67 ± 0.47 to 15.22 ± 5.58 cm3, in accordance with the cubic model y = –2.729 + 0.0012 × age3 ± 1.598 (R2 = 0.83). The mean volumes of the right and left lungs accounted for 54.9 ± 2.0 and 45.1 ± 2.0 %, respectively, of the total lung volume.ConclusionsNo sex differences are found between the lung volumes in the fetus. The growth of fetal lung volume follows a three-degree polynomial function. Throughout the analyzed period the two lungs grow proportionately to each other, with the volumetric predominance of the right lung. The lung volumes in the fetus are of great relevance in the evaluation of the normal pulmonary growth and the diagnosis of pulmonary hypoplasia.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Volumetric growth of the lungs in human fetuses: an anatomical, hydrostatic and statistical study

et al. 2014

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“…After overnight formalin fixation, the lung volume was determined according to Archimedes' principle by water immersion, a method particularly suitable for determination of small organ volumes . The observed postmortem lung volume values thus obtained in the current study corresponded well with previously reported normal values …”

Section: Discussionsupporting

confidence: 92%

Postmortem lung volume/body weight standards for term and preterm infants

Paepe

Shapiro

Hansen

et al. 2013

Pediatric Pulmonology

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Assessment of lung growth is a critical component of the perinatal autopsy. Increased lung liquid content may lead to overestimation of lung growth based on (wet) lung weight. In contrast, lung volume is not influenced by intraalveolar lung liquid. Our aim was to establish age-specific reference values for postmortem lung volume/BW in preterm and term infants. We performed a retrospective analysis of fetuses/infants (16-41 weeks' gestation) without (N = 134) or with (N = 79) risk factors for pulmonary hypoplasia. Lungs were inflated at standardized pressure and volumes determined by water immersion method. Lung volume increased 11-fold between 16 and 41 weeks' gestation, concomitant with a 16-fold increase in BW. Mean lung volume/BW remained constant at 33-34 ml/kg between 16 and 31 weeks' gestation and decreased to 23.4 ml/kg at term. Lung volume/BW of infants with severe risk factors (renal anomalies, diaphragmatic hernia) was significantly lower than age-matched standards. In this group, all fetuses/infants diagnosed as having lung hypoplasia by lung volume/BW also had lung hypoplasia LW/BW standards. However, in infants with "softer" risk factors (rupture of membranes, chromosomal anomalies), 5/26 cases diagnosed with lung hypoplasia based on lung volume/BW had normal LW/BW ratios. In these discrepant cases, lung sections showed significant inflammation and edema, likely accounting for increased wet lung weight. In conclusion, we determined age-specific lung volume/BW reference values for preterm and term infants. In selected situations assessment of lung volume/BW may represent a useful complementary tool to LW/BW for postmortem evaluation of lung size.

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“…We also compared our graphs with fetopathological standards given by Langston et al 46 and more recently by De Paepe et al 47, although we realize that it is difficult to compare postmortem pathological studies with a sonographic study. The volumes measured in our study were still below the volumes obtained from the pathological studies, but correlated better than did earlier 3D ultrasound studies19, 21–26, 34.…”

Section: Discussionmentioning

confidence: 99%