Preliminary report on a new and noninvasive method for the assessment of fetal lung maturity
-
R. La Torre
Abstract
Object: Several patterns of fetal breathing movements (FBMs), i.e. abdominal wall movements (AWm), thoracic wall movements (TWm) and nasal fluid flow velocity waveforms (NFFVW), were investigated by ultrasound (US) technology and related to fetal pulmonary maturity and immaturity, i.e. fetal lung maturity (FLM) tests, in order to validate the hypothesis that they may indicate whether the fetal lung is mature or immature, regardless of gender, weight and gestational age.
Material and methods: We prospectively enrolled 143 high-risk pregnancies in which a complete US study of FBMs and FLM tests was performed. Among them 43 women satisfied the inclusion criteria. US-FLM was defined as the presence of regular NFFVW detected by pulsed Doppler and spectral analysis, or irregular NFFVW synchronous with TWm detected by M-mode. An US guided amniocentesis was performed in order to collect amniotic fluid (AF) and FLM was evaluated by L/S (lecithin/sphingomyelin) determination, presence of phosphatidylglycerol (PG) and lamellar bodies (LBs) count. At the end of the study the diagnostic accuracy of US-FLM was compared to that of FLM tests.
Results: Diagnostic accuracy for US evaluation of FLM was as follows: sensitivity: 89,6%; specificity: 85,7%; PPV: 92,8%; NPV: 80%. Diagnostic accuracy of FLM tests was as follows: sensitivity: 100%;specificity: 51,7%; PPV: 100%; NPV: 50%. L/S determination predicted lung maturity with a sensitivity of 100%; specificity of 93,1%; PPV of 100%; NPV of 87,5%.
Conclusion: Presence of regular NFFVW or irregular NFFVW and TWm correlate accurately with conventional FLM tests. We suggest that this noninvasive procedure may be helpful for assessing FLM, particularly under certain circumstances, e.g., oligo-anhydramnios, laboratory logistic equipment difficulties or heavily stained AF samples, amniocentesis refusal, religious concerns.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- Message from the President of the WCPM
- Message from the President of the WAPM
- Antalya Consensus on Perinatal Care:The Report of the 2nd World Congress of Perinatal Medicine for Developing Countries, 1–5 October 2002, Antalya, Turkey
- Reduction in mortality needs a bit more than the science of perinatology
- Global, regional and national perinatal and neonatal mortality
- Maternal mortality in Turkey
- Maternal mortality in developing countries
- Organization of neonatal care services and its importance
- The Misgav Ladach method – a step forward in operative technique in obstetrics
- Monitoring the IUGR fetus
- Massive obstetric hemorrhage
- Breech deliveries and cesarean section
- Iron supplementation in pregnancy
- Antenatal diagnosis and prognosis of conjoined twins – a case report
- Preliminary report on a new and noninvasive method for the assessment of fetal lung maturity
- Perinatal mortality rate – hospital based study during 1998–2001 at Hacettepe University
- The effect of glucocorticoid therapy on prevention of early neonatal complications in preterm delivery
- Congress Calendar
Articles in the same Issue
- Message from the President of the WCPM
- Message from the President of the WAPM
- Antalya Consensus on Perinatal Care:The Report of the 2nd World Congress of Perinatal Medicine for Developing Countries, 1–5 October 2002, Antalya, Turkey
- Reduction in mortality needs a bit more than the science of perinatology
- Global, regional and national perinatal and neonatal mortality
- Maternal mortality in Turkey
- Maternal mortality in developing countries
- Organization of neonatal care services and its importance
- The Misgav Ladach method – a step forward in operative technique in obstetrics
- Monitoring the IUGR fetus
- Massive obstetric hemorrhage
- Breech deliveries and cesarean section
- Iron supplementation in pregnancy
- Antenatal diagnosis and prognosis of conjoined twins – a case report
- Preliminary report on a new and noninvasive method for the assessment of fetal lung maturity
- Perinatal mortality rate – hospital based study during 1998–2001 at Hacettepe University
- The effect of glucocorticoid therapy on prevention of early neonatal complications in preterm delivery
- Congress Calendar
