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Predictive value of fetal lung volume in prenatally diagnosed skeletal dysplasia
Author(s) -
Weaver K. Nicole,
Johnson Jodie,
KlineFath Beth,
Zhang Xue,
Lim FoongYen,
Tinkle Brad,
Saal Howard M.,
Hopkin Robert J.
Publication year - 2014
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4475
Subject(s) - medicine , fetus , magnetic resonance imaging , lung , bronchopulmonary dysplasia , dysplasia , ultrasound , radiology , gestational age , pathology , nuclear medicine , pregnancy , biology , genetics
Objective Pulmonary hypoplasia is a major cause of death in lethal skeletal dysplasias. We hypothesize that in fetuses with prenatally diagnosed skeletal dysplasia, comparison of observed‐to‐expected (O/E) lung volume will help predict lethality. Study design We conducted a retrospective chart review of patients referred for evaluation of suspected fetal skeletal anomalies. Twenty‐three pregnancies were identified with confirmed fetal diagnosis of skeletal dysplasia for which fetal magnetic resonance imaging (MRI) was performed between 21 and 38 weeks of gestation and ultrasound biometry data were available. Femur length to abdominal circumference ratio (FL/AC) and O/E lung volumes were calculated. The association between O/E lung volume, FL/AC, and lethality was measured using logistic regression. Results Lethality was significantly associated with O/E lung volume ( p = 0.002) and FL/AC ( p = 0.0476). Analysis with receiver‐operating characteristic curves suggested that O/E lung volume of 47.9% or FL/AC of 0.124 could be useful clinical cutoffs in the prediction of lethality. Conclusion In fetuses with skeletal dysplasia , fetal MRI‐derived O/E lung volume was predictive of lethality. When evaluating a fetal skeletal dysplasia, fetal MRI may be considered in cases for which ultrasound‐based lethality prediction is ambiguous or uncertain in order to provide families with the most complete and accurate information. © 2014 John Wiley & Sons, Ltd.