Prediction of lethal pulmonary hypoplasia among high-risk fetuses via 2D and 3D ultrasonography

Prediction of lethal pulmonary hypoplasia among high-risk fetuses via 2D and 3D ultrasonography

Author Rezende, Guilherme de Castro Google Scholar
Pereira, Alamanda Kfoury Google Scholar
Araujo Junior, Edward Autor UNIFESP Google Scholar
Nogueira Reis, Zilma Silveira Google Scholar
Vieira Cabral, Antonio Carlos Google Scholar
Institution Universidade Federal de Minas Gerais (UFMG)
Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: To compare accuracy between 3D and 2D ultrasonography for predicting lethal pulmonary hypoplasia (LPH) among high-risk fetuses. Methods: in a cross-sectional prospective study at a fetal medicine referral center in Brazil, bilateral fetal lung scans were evaluated for 54 fetuses with suspected LPH between May 2008 and June 2011. Measurements for predicting LPH were ultrasonographic fetal lung volume/estimated fetal weight ratio (US-FLW), observed/expected thoracic circumference (o/e-TC), observed/expected thoracic circumference/abdominal circumference (o/e-TC/AC), observed/expected thoracic area/heart area (o/e-TA/HA), observed/expected amniotic fluid index (o/e-AFI), and observed/expected total fetal lung volume (o/e-Tot-FLV). To evaluate accuracy in predicting LPH, receiver operating characteristic (ROC) curves were calculated, and areas under the curves (AUCs) were compared. the intraclass correlation coefficient (ICC) was used to assess 3D lung volume reproducibility. Results: Data were compared for 47 newborns, of whom 34 had LPH (perinatal mortality 74.5%). the AUCs for predicting LPH were 0.93, 0.69, 0.55, 0.46, 0.71, and 0.86 for US-FLW, o/e-TC, o/e-TC/AC, o/e-TA/HA, o/e-AFI, and o/e-Tot-FLV, respectively. No significant intraobserver difference was observed in measurements of the right (ICC, 0.973; P < 0.0001) or left (ICC, 0.950; P < 0.0001) lung volumes. Conclusion: Among high-risk fetuses, US-FLW by 20/3D and o/e-Tot-FLV by 3D ultrasonography were more accurate than 20 parameters for predicting LPH. (C) 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Keywords Prenatal diagnosis
Pulmonary hypoplasia
2D ultrasonography
3D ultrasonography
Language English
Date 2013-10-01
Published in International Journal of Gynecology & Obstetrics. Clare: Elsevier B.V., v. 123, n. 1, p. 42-45, 2013.
ISSN 0020-7292 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 42-45
Access rights Closed access
Type Article
Web of Science ID WOS:000325122400011

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