Prediction of neonatal respiratory distress in pregnancies complicated by fetal lung masses

Girsén, Anna; Hintz, Susan R.; Sammour, Rami N.; Naqvi, Aasim; El‐Sayed, Yasser Y.; Sherwin, Katie; Davis, Alexis S.; Chock, Valerie Y.; Barth, Richard A.; Rubesova, Erika; Sylvester, Karl G.; Chitkara, Rajinder K.; Blumenfeld, Yair J.

doi:10.1002/pd.5002

Cited by 35 publications

(31 citation statements)

References 15 publications

(35 reference statements)

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“…Overall, most of these outcomes are rare in large published series, with recent reports indicating survival of greater than 95% . On the other hand, respiratory morbidity has been found to complicate 9% to 25% of neonates with CLLs, depending on the definitions used in the literature . Severe respiratory morbidity has been documented in approximately 10% of neonates .…”

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confidence: 99%

“…On the other hand, respiratory morbidity has been found to complicate 9% to 25% of neonates with CLLs, depending on the definitions used in the literature . Severe respiratory morbidity has been documented in approximately 10% of neonates . Identifying fetuses that might be at risk for substantial respiratory morbidity will aid in counseling, appropriate postnatal management planning with respect to the delivery location, involvement of neonatology and the need for neonatal intensive care unit (NICU) admission, and the appropriate choice and timing of postnatal imaging.…”

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confidence: 99%

“…Prenatal prediction remains challenging. Several recent reports focused on the role of the congenital pulmonary malformation volume ratio (CVR) in predicting neonatal respiratory morbidity and NICU admission . There is a variability in published studies with respect to the proposed CVR cutoffs and the criteria used to define neonatal respiratory morbidity .…”

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confidence: 99%

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Utility of Fetal Cardiac Axis and Cardiac Position Assessment in Predicting Neonatal Respiratory Morbidity in Fetal Congenital Lung Lesions

Tuzović

Copel

Stitelman

et al. 2019

J of Ultrasound Medicine

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Objectives-To assess the diagnostic performance of the fetal cardiac axis (CA) and/or cardiac position (CP) versus the congenital pulmonary malformation volume ratio (CVR) in predicting any and severe neonatal respiratory morbidity in fetal congenital lung lesions.Methods-This work was an 11-year retrospective cohort study. The sensitivity, specificity, positive predictive value, and negative predictive value of CA and/or CP assessment in prediction of respiratory morbidity were calculated before 24 weeks' gestation and between 24 and 32 weeks and compared to CVR cutoffs obtained from the literature.Results-Fifty-three patients were included. CA and/or CP abnormalities were present in 45% and 38% of patients before 24 weeks and between 24 and 32 weeks and were significantly more common in left-versus rightsided lesions (60% versus 17%; P = .003). The sensitivity, specificity, positive predictive value, and negative predictive value of an abnormal CA and/or CP for any and severe respiratory morbidity were 0.67, 0.61, 0.33, and 0.86 and 0.8, 0.58, 0.17, and 0.97 before 24 weeks and 0.75, 0.73, 0.45, and 0.91 and 0.8, 0.67, 0.20, and 0.97 between 24 and 32 weeks, respectively. An abnormal CA and/or CP had higher sensitivity for any respiratory morbidity compared to the CVR at 0.5 and 0.8 cutoffs both before 24 weeks and between 24 and 32 weeks (P < .05).Conclusions-An abnormal CA and/or CP before 24 weeks and between 24 and 32 weeks has higher sensitivity for the detection of any respiratory morbidity at birth compared to the CVR at both 0.5 and 0.8 cutoffs. A normal CA and CP have a high negative predictive value for excluding any respiratory morbidity at birth both before 24 weeks and between 24 and 32 weeks.

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confidence: 99%

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confidence: 99%

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Utility of Fetal Cardiac Axis and Cardiac Position Assessment in Predicting Neonatal Respiratory Morbidity in Fetal Congenital Lung Lesions

Tuzović

Copel

Stitelman

et al. 2019

J of Ultrasound Medicine

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“…Magnetic resonance imaging is reported to provide alternative or additional diagnoses in 38 to 50% of fetuses with a sonographically diagnosed lung mass . Magnetic resonance imaging can also predict the risk for neonatal respiratory distress in the setting of a fetal lung mass . The added information is often important for parental counseling, planning delivery location, and clinical management decisions.…”

Section: First Debater: Dr Richard a Barth MD (Stanford)—yes All Pmentioning

confidence: 99%

“…of a fetal lung mass. 7 The added information is often important for parental counseling, planning delivery location, and clinical management decisions.…”

Section: Introduction (Lawrence Platt)mentioning

confidence: 99%

Current controversies in prenatal diagnosis 3: Fetal MRI should be performed in all prenatally detected fetuses with a major structural abnormality

Platt¹,

Barth

Pugash

2018

Prenatal Diagnosis

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Prenatal sonographic markers of the outcome in fetuses with bronchopulmonary sequestration

Cho

Lee

Kang

et al. 2019

J of Clinical Ultrasound

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PurposeTo evaluate the prenatal sonographic predictive markers of the outcome in fetuses with bronchopulmonary sequestration (BPS).MethodsBPS size and diameter of the feeding artery (FA) were measured prenatally and postnatally. Velocity of the FA and the left ventricular‐modified myocardial performance index (LV mod‐MPI) were also evaluated prenatally.ResultsForty‐seven women were included in the study. Mean gestational age, mass size, diameter and velocity of the FA, and LV mod‐MPI at prenatal diagnosis were 23.5 ± 2.2 weeks, 3.6 ± 8.3 cm, 2.3 ± 0.6 mm, 46.6 ± 15.4 cm/s, and 0.46 ± 0.06, respectively. Mean mass diameter and FA diameter measured on postnatal CT examinations were 3.8 ± 1.0 cm and 2.3 ± 0.7 mm, respectively. Five patients had respiratory symptoms after birth. Twenty children (43%) underwent or were scheduled to undergo mass excision, and the remaining 27 (57%) were doing well without any intervention. There was no neonatal death. LV mod‐MPI at diagnosis, the FA diameter after birth and the serial change in the FA size were significantly associated with postnatal mass excision.ConclusionThe FA diameter and LV mod‐MPI may be additional markers for predicting whether fetuses with BPS should undergo mass excision in early childhood or conservative care.

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Prediction of neonatal respiratory distress in pregnancies complicated by fetal lung masses

Abstract: Ultrasound and MRI parameters can predict neonatal respiratory distress, even when obtained before 24 weeks. Third trimester parameters demonstrated the best positive predictive value. © 2017 John Wiley & Sons, Ltd.

Cited by 35 publications

References 15 publications

Utility of Fetal Cardiac Axis and Cardiac Position Assessment in Predicting Neonatal Respiratory Morbidity in Fetal Congenital Lung Lesions

Utility of Fetal Cardiac Axis and Cardiac Position Assessment in Predicting Neonatal Respiratory Morbidity in Fetal Congenital Lung Lesions

Current controversies in prenatal diagnosis 3: Fetal MRI should be performed in all prenatally detected fetuses with a major structural abnormality

Prenatal sonographic markers of the outcome in fetuses with bronchopulmonary sequestration

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