Pulmonary hypoplasia: Pathogenesis, diagnosis, and antenatal prediction

Lauria, Michele R.; Gonik, Bernard; Romero, Roberto

doi:10.1016/0029-7844(95)00195-w

Cited by 115 publications

(57 citation statements)

References 61 publications

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“…4 A critical amount of amniotic fluid volume appears to be vital to a proper lung development, perhaps by preventing mechanical compression of fetal thorax and maintaining normal pressure gradient in the pulmonary system and normal amniotic fluid flow in the fetal lungs. 5 The main aim of our study was to evaluate the effects of transabdominal amnioinfusion as regards pPROMdelivery interval. The secondary aim was to assess the impact on caesarean section rate, pulmonary hypoplasia and abnormal neurological outcomes compared with expectant management.…”

Section: Introductionmentioning

confidence: 99%

Transabdominal amnioinfusion in preterm premature rupture of membranes: a randomised controlled trial

Tranquilli

Giannubilo

Bezzeccheri

et al. 2005

BJOG

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Objective To evaluate the role of transabdominal amnioinfusion in improving the perinatal outcomes of pregnancies complicated by preterm premature rupture of membranes (pPROM). Design A randomised controlled trial.Setting A teaching hospital in Italy, obstetric unit.Population Women with singleton pregnancies complicated by pPROM, between 24 þ 0 and 32 þ 6 weeks of gestation. Methods Patients were randomised 24 hours after admission to our referral hospital, to expectant management with transabdominal amnioinfusion or expectant management only. Main outcome measures The effects of transabdominal amnioinfusion on pPROM -delivery interval and on perinatal outcomes. Results Of the 65 women with pPROM 34 met the inclusion criteria. Seventeen women were assigned to amnioinfusion (the amnioinfusion group) and the other 17 to expectant management. Compared with the control group (median: 8 days; range: 3 -14), the pPROM -delivery period was significantly longer in women who underwent amnioinfusion (median: 21 days; range: 15-29) (P < 0.05). Women with amnioinfusion were less likely to deliver within seven days since pPROM (RR: 0.18; range: 0.04 -0.69 95% CI) or within two weeks (RR: 0.46; range: 0.21 -1.02 95% CI). In the amnioinfusion group the neonatal survival was significantly higher at each gestational age (P < 0.01, Yates's correction for Log Rank Test) with a reduction in pulmonary hypoplasia. Conclusions We demonstrated that compared with standard expectant management the treatment with transabdominal amnioinfusion after pPROM resulted in significant prolongation of pregnancy and better neonatal outcomes.

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Section: Introductionmentioning

confidence: 99%

Transabdominal amnioinfusion in preterm premature rupture of membranes: a randomised controlled trial

Tranquilli

Giannubilo

Bezzeccheri

et al. 2005

BJOG

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“…Pulmonary hypoplasia, whether caused by loss of lung fluid, thoracic compression, or inhibition of fetal breathing movements, is associated with a high perinatal mortality rate [1,2]. Determining the degree of pulmonary hypoplasia and, more specifically, distinction between lethal and nonlethal forms of pulmonary hypoplasia can aid in the selection of antenatal management approaches, including termination of pregnancy, timed delivery with appropriate postnatal therapy, or, if applicable, fetal intervention.…”

Section: Introductionmentioning

confidence: 99%

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

2003

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Objective: To determine the validity of existing imaging-derived formulas for predicting the fetal lung volume (FLV). Methods: In a consecutive series of postmortem lungs without pulmonary anomalies, the observed FLV (FLV_obs) after inflation was correlated with individual fetal variables used in imaging-derived formulas. In addition, FLV_obs was correlated with the predicted FLV calculated according to these same formulas. Results: Postmortem FLV_obs showed a strong correlation with estimated fetal body weight, biparietal diameter, and head circumference (r > 0.9). The correlation of FLV_obs with gestational age, femur length, and liver weight was less strong (0.8 < r < 0.9). The correlation was strongest for midgestation fetuses (between 22 and 32 weeks’ gestation). The predicted FLV calculated using formulas based on fetal body weight, biparietal diameter, and head circumference showed the strongest correlation with the actual FLV_obs (r > 0.9). Conclusions: Postmortem FLV_obs strongly correlates with fetal body weight, biparietal diameter, and head circumference, especially in midgestation fetuses. Regression formulas based on these fetal variables provide the most accurate prediction of FLV.

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“…Studies of neonates with congenital diaphragmatic hernias indicate that at least 45% of the lung volume is needed for good outcome [4]. Lung development is thought to be most severely compromised when occurring in the third trimester [5]. By ultrasonographic studies, the fetus in this case first demonstrated lung compression at Choi/Jaffe/Maidman/Baxi 27-30 weeks, with the heart occupying 50% of the thoracic cavity.…”

Section: Discussionmentioning

confidence: 93%

Multiple Cardiac Rhabdomyomas Detected in utero

et al. 2000

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Pulmonary hypoplasia: Pathogenesis, diagnosis, and antenatal prediction

Abstract: For patients with premature rupture of membranes, the gestational age at time of rupture carries the highest risk correlation with subsequent pulmonary hypoplasia.

Cited by 115 publications

References 61 publications

Transabdominal amnioinfusion in preterm premature rupture of membranes: a randomised controlled trial

Transabdominal amnioinfusion in preterm premature rupture of membranes: a randomised controlled trial

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

Multiple Cardiac Rhabdomyomas Detected in utero

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