Predicting Fetal Lung Maturity Using the Fetal Pulmonary Artery Doppler Wave Acceleration/Ejection Time Ratio

Abstract

Objective: To determine whether the acceleration/ejection time ratio of the fetal main pulmonary artery Doppler waveform (PATET) can accurately predict the results of fetal lung maturity testing in amniotic fluid. Methods: We prospectively studied pregnant women attending our ultrasound unit for clinically indicated fetal lung maturity testing. An ultrasound examination that included measurement of the PATET was performed before the results of the amniocentesis were reported. The results of the PATET and the surfactant/albumin ratio were compared, and a receiver operating characteristic curve was used to determine the PATET cutoff with the optimal sensitivity and specificity for predicting surfactant/albumin ratio results. p < 0.05 was considered statistically significant. Results: Forty-three patients were included in this study. The receiver operating characteristic curve demonstrated that a PATET cutoff of 0.3149 provided a specificity of 93% (95% CI 77-98%), a sensitivity of 73% (95% CI 48-89%), a negative predictive value of 87% (95% CI 70-95%), and a positive predictive value of 85% (95% CI 58-96%) for predicting immature surfactant/albumin ratio results. Conclusion: The PATET may provide a noninvasive means of determining fetal lung maturity with acceptable levels of sensitivity, specificity, and predictive values.

Diagnóstico de madurez pulmonar fetal por velocímetro doppler

“…Estos puntos de inflexión coinciden con el desarrollo prenatal del pulmón fetal. Además de estos parámetros hemos evaluado también los parámetros del tiempo de aceleración y tiempo de eyección de la arteria pulmonar, ya bastante estudiado por otros autores (9,19,24), y su relación con la edad gestacional y la madurez pulmonar (Datos que no se muestran en este estudio). Hemos visto que de todos los parámetros estudiados, los cambios más evidentes ocurren a nivel de la VmxDA, siendo este parámetro el que presenta mayor relación con la edad gestacional y madurez pulmonar.…”

“…Según estudio de la relación del tiempo de aceleración y el tiempo de eyección de la arteria pulmonar puede proporcionar un medio no invasivo para determinar la madurez pulmonar fetal con niveles aceptables de sensibilidad, especificidad y valores predictivos (24). En este estudio refieren un sensibilidad del 73% y una especificidad del 93% tras la evaluación del cociente aceleración eyección, ya descrito por otros autores (9,19).…”

Doppler evaluation of the fetal pulmonary artery pressure

“…Several studies have reported reference values for variables such as systolic and diastolic velocities, pulsatility index, acceleration time, deceleration time and ejection time for gestational age (GA). Some of these have been used for practical purposes, such as methods of predicting fetal lung maturity [1,2].…”

Quantitative Ultrasound Texture Analysis for Differentiating Preterm From Term Fetal Lungs

“…Some have focused on direct assessment of the fetal lung by measurement of fetal lung volumes. Others have relied on indirect associations with fetal lung maturity, including placental grading, measurement of epiphysis ossification centers, and pulmonary artery Doppler studies . Furthermore, accurately predicting lethal pulmonary hypoplasia in the fetus has also proven difficult by ultrasound imaging …”

“…Others have relied on indirect associations with fetal lung maturity, including placental grading, measurement of epiphysis ossification centers, and pulmonary artery Doppler studies. [7][8][9] Furthermore, accurately predicting lethal pulmonary hypoplasia in the fetus has also proven difficult by ultrasound imaging. 10 Quantitative ultrasound texture analysis of the fetal lung has been proposed as a promising noninvasive method to predict fetal lung maturity, fetal lung hypoplasia, and neonatal respiratory morbidity.…”