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Volume Volume 18, 2024 · Issue 1 · Open Access · Double-blind Peer-review

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Hypothesis

Fetal Pulmonary Artery Doppler's Predictive Usefulness in Newborn Respiratory Distress Syndrome

Mohamed Ali Mahmoud Abbas1 & Tasnem Ragaa Mayallo2

1 Department of medical physiology, Damietta Faculty of medical, Al Azhar University, Egypt.

2 Obstetrics and Gynecology Department, Ministry of Health, Damietta, Egypt.

* Corresponding author: Mohamed Ali Mahmoud Abbas ([email protected])

Published: 30 Jun 2024

https://doi.org/10.35192/jjoas-n.v18i1.1848
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Abstract

Background: The most common cause of respiratory distress in premature infants is newborn respiratory distress syndrome (RDS). When evaluating the pulmonary circulation of a growing fetus, Doppler velocimetry offers a quick and painless method. Decreased pulmonary surfactant levels are linked to RDS, which is a major cause of infant morbidity and mortality since the pulmonary system is the last organ system in the fetus to physiologically mature before extrauterine life.

Aim: This study aims to determine if fetal main pulmonary artery (MPA) Doppler indices can predict neonatal RDS.

Methods: The study included 100 pregnant patients from the Obstetrics and Gynecology Department at Damietta Specialized Hospital, comprising 11 with RDS and 89 without RDS. The Apgar score and the newborn's birth weight (NBW) were recorded at 1 and 5 minutes. Clinical indicators of respiratory distress included the need for supplemental oxygen of 0.4 or more for at least one day, alongside typical chest X-ray findings.

Results: Neonates with RDS had statistically significant lower acceleration time/ejection time ratios, peak systolic velocity (PSV), and systolic/diastolic (S/D) ratios, as well as significantly higher pulsatility index (PI) and resistance index (RI) compared to those without RDS. At a cutoff level of >0.785, the resistance index (RI) had a sensitivity of 100% and specificity of 100% for predicting RDS.

Conclusion: Predicting fetal lung maturity and the subsequent development of newborn RDS with high levels of specificity and sensitivity is possible using fetal pulmonary artery indices.

KeywordsDoppler indicesPulmonary arteryNeonatal respiratory

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References

  1. Liu J. Respiratory distress syndrome in full-term neonates. J Neonatal Biol 2012; S1: e001. DOI: 10.4172/2167-0897.S1-e001
  2. Kamath BD, Macguire ER, McClure EM, Goldenberg RL, Jobe AH. Neonatal mortality from respiratory distress syndrome: lessons for low-resource countries. Pediatrics. 2011 Jun;127(6):1139-46. doi: 10.1542/peds.2010-3212.
  3.  Spong CY, Mercer BM, D'Alton M, Kilpatrick S, Blackwell S, Saade G. Timing of indicated late-preterm and early-term birth. Obstet Gynecol. 2011 Aug;118(2 Pt 1):323-333. doi: 10.1097/AOG.0b013e3182255999.
  4. Schenone MH, Samson JE, Jenkins L, Suhag A, Mari G. Predicting fetal lung maturity using the fetal pulmonary artery Doppler wave acceleration/ejection time ratio. Fetal Diagn Ther. 2014;36(3):208-14. doi: 10.1159/000358299.
  5. Kim SM, Park JS, Norwitz ER, Hwang EJ, Kang HS, Park CW, Jun JK. Acceleration time-to-ejection time ratio in fetal pulmonary artery predicts the development of neonatal respiratory distress syndrome: a prospective cohort study. Am J Perinatol. 2013 Nov;30(10):805-12. doi: 10.1055/s-0032-1333132.
  6. Guan Y, Li S, Luo G, Wang C, Norwitz ER, Fu Q, Tu X, Tian X, Zhu J. The role of doppler waveforms in the fetal main pulmonary artery in the prediction of neonatal respiratory distress syndrome. J Clin Ultrasound. 2015 Jul-Aug;43(6):375-83. doi: 10.1002/jcu.22219.
  7. Daniel, W. Biostatistics: A foundation for Analysis in the Health Sciences, 1999, 7th ed. New York: John Wiley and Sons.
  8. Khalil, O. A., Abdel Ghany, H. S., Osman, N. M. M., & Abdelhamid, M. K. (2019). The role of different fetal pulmonary artery Doppler indices in the prediction of neonatal respiratory distress syndrome. Minia Journal of Medical Research, 30(2), 64-71.
  9. Alsheikh AM, Elsadek AM, Gebreel S A. Relation Between Fetal Doppler Pulmonary Artery Indices and Neonatal Respiratory Distress Syndrome In Term Neonates. International Journal of Medical Arts, 2021; 3(1), 1046-1052. Doi:  10.21608/IJMA.2020. 43097.1172
  10. Büke B, Destegül E, Akkaya H, Şimşek D, Kazandi M. Prediction of neonatal respiratory distress syndrome via pulmonary artery Doppler examination. J Matern Fetal Neonatal Med. 2019 May;32(10):1640-1645. doi: 10.1080/14767058.2017.1413549.
  11. Abdelhamid MK, Ghani HS, Khalil OA, El-Gelany S, Osman NM. Quantitative ultrasound texture analysis of fetal lung versus fetal pulmonary artery Doppler as a predictor of neonatal respiratory distress syndrome (RDS). International Journal of Medical Imaging, 2020; 8(2), 23. doi: 10.11648/j.ijmi.20200802.12
  12. Eldeeb B., El-Shourbagy KH, El-Shorbagy SH. Which is more accurate measuring pulmonary artery resistance index or 4D lung volume for prediction of neonatal respiratory distress in preterm pregnancies?. Egypt J Radiol Nucl Med. 2023; 54, 30.
  13. Keshuraj V, Prakash A, Boruah DK. Validity of Fetal Doppler indices in predicting postnatal respiratory distress syndrome: a prospective study. Egypt J Radiol Nucl Med. 2022; 53, 183. https://doi.org/10.1186/s43055-022-00865-2
  14. Laban M, Mansour GM, Elsafty MS, Hassanin AS, EzzElarab SS. Prediction of neonatal respiratory distress syndrome in term pregnancies by assessment of fetal lung volume and pulmonary artery resistance index. Int J Gynaecol Obstet. 2015 Mar;128(3):246-50. doi: 10.1016/j.ijgo.2014.09.018.
  15. Moety GA, Gaafar HM, El Rifai NM. Can fetal pulmonary artery Doppler indices predict neonatal respiratory distress syndrome? J Perinatol. 2015 Dec;35(12):1015-9. doi: 10.1038/jp.2015.128. Epub 2015 Oct 22. PMID: 26491853.
  16. Li Q, Xu L, Zhang L. The Role and Clinical Value of Optimized Fetal Main Pulmonary Artery Doppler Parameters in the Diagnosis and Prognosis Monitoring of Neonatal Respiratory Distress Syndrome. Computational and Mathematical Methods in Medicine, 2022.  https://doi.org/10.1155/2022/1682225.
  17. Wang S, Wang Y, Gao M, Tan Y. Acceleration time to Ejection time ratio in fetal pulmonary artery system can predict neonatal respiratory disorders in gestational diabetic mellitus women. Clin Hemorheol Microcirc. 2022;80(4):497-507. doi: 10.3233/CH-211265.
  18. Taha HMG, GhorabNMA, Al-NamoryMM, HusseinNA. Role of fetal pulmonary artery Doppler in prediction of neonatal respiratory distress in neonates of diabetic mothers. Int J Reprod Contracept Obstet Gynecol; 2022; 11:3236-41.
  19. Khalifa YEA, Aboulghar MM, Hamed ST, Tomerak RH, Asfour AM, Kamal EF. Prenatal prediction of respiratory distress syndrome by multimodality approach using 3D lung ultrasound, lung-to-liver intensity ratio tissue histogram and pulmonary artery Doppler assessment of fetal lung maturity. Br J Radiol. 2021 Dec;94(1128):20210577. doi: 10.1259/bjr.20210577. PMC8631030.
  20. Guan Y, Li S, Luo G, Wang C, Norwitz ER, Fu Q, Tu X, Tian X, Zhu J. The role of doppler waveforms in the fetal main pulmonary artery in the prediction of neonatal respiratory distress syndrome. J Clin Ultrasound. 2015 Jul-Aug;43(6):375-83. doi: 10.1002/jcu.22219.