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Prediction of lethal pulmonary hypoplasia and chorioamnionitis by assessment of fetal breathing
Author(s) -
OHLSSON ARNE,
FONG KATHERINE,
HANNAH MARY,
HEYMAN ZAHAVA,
GONEN RON,
ROSE TOBY,
BABOOLAL RANJIT
Publication year - 1991
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1991.tb13457.x
Subject(s) - medicine , chorioamnionitis , pulmonary hypoplasia , fetus , bronchopulmonary dysplasia , obstetrics , amniotic fluid index , amniotic fluid , hypoplasia , gestational age , pregnancy , genetics , biology
Summary. Twenty‐three pregnancies with fetuses at risk for pulmonary hypoplasia were studied weekly until delivery. The amount of time spent in fetal breathing activity was recorded under controlled conditions during 1 h using real‐time ultrasound. An amniotic fluid index was determined. The clinicians and the pathologist were unaware of the ultrasound findings. Eight of 23 fetuses did not breathe at the last ultrasound examination. Three babies died of pulmonary hypoplasia and two of these showed fetal breathing before birth. The three deaths were associated with rupture of the membranes at <20 weeks gestation and of ≥44 days duration. One infant developed bronchopulmonary dysplasia. The amniotic fluid index in these four pregnancies was low and the newborn infants had limb contractures. Chorioamnionitis/funisitis was noted in 13 placentas. Eight fetuses were assessed for fetal breathing within 2 days of birth. The lack of fetal breathing had sensitivity, specificity, positive and negative predictive values of 0.75 for chorioamnionitis/funisitis. In this pilot study the absence of fetal breathing was of no value in predicting lethal pulmonary hypoplasia, but was related to chorioamnionitis/funisitis. We recommend further studies of fetal breathing in relation to fetal/neonatal infections.