Premium
Prediction of neonatal respiratory distress in pregnancies complicated by fetal lung masses
Author(s) -
Girsen Anna I.,
Hintz Susan R.,
Sammour Rami,
Naqvi Aasim,
ElSayed Yasser Y.,
Sherwin Katie,
Davis Alexis S.,
Chock Valerie Y.,
Barth Richard A.,
Rubesova Erika,
Sylvester Karl G.,
Chitkara Ritu,
Blumenfeld Yair J.
Publication year - 2017
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.5002
Subject(s) - medicine , respiratory distress , gestational age , lung , lung volumes , tidal volume , magnetic resonance imaging , extracorporeal membrane oxygenation , predictive value of tests , respiratory system , positive predicative value , predictive value , ventilation (architecture) , obstetrics , pregnancy , radiology , mechanical engineering , biology , genetics , engineering
Objective The objective of this article is to evaluate the utility of fetal lung mass imaging for predicting neonatal respiratory distress. Method Pregnancies with fetal lung masses between 2009 and 2014 at a single center were analyzed. Neonatal respiratory distress was defined as intubation and mechanical ventilation at birth, surgery before discharge, or extracorporeal membrane oxygenation (ECMO). The predictive utility of the initial as well as maximal lung mass volume and congenital pulmonary airway malformation volume ratio by ultrasound (US) and magnetic resonance imaging (MRI) was analyzed. Results Forty‐seven fetal lung mass cases were included; of those, eight (17%) had respiratory distress. The initial US was performed at similar gestational ages in pregnancies with and without respiratory distress (26.4 ± 5.6 vs 22.3 ± 3 weeks, p = 0.09); however, those with respiratory distress had higher congenital volume ratio at that time (1.0 vs 0.3, p = 0.01). The strongest predictors of respiratory distress were maximal volume >24.0 cm 3 by MRI (100% sensitivity, 91% specificity, 60% positive predictive value, and 100% negative predictive value) and maximal volume >34.0 cm 3 by US (100% sensitivity, 85% specificity, 54% positive predictive value, and 100% negative predictive value). Conclusion 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.