Comparative analysis of ultrasonographic fetal lung texture in twin and singleton fetuses
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Nathan A. Keller
,
Luis A. Bracero
,
Frank I. Jackson
Abstract
Objectives
Increased fetal lung heterogeneity has been associated with term fetal lungs in singleton gestations. The objective of this study was to determine if fetal lung heterogeneity index (HI) differs between twin and singleton fetuses in the late second and third trimesters.
Methods
Prospective cohort study of women with singleton and twin gestations with medically-indicated ultrasound examinations at 24 weeks of gestation onward. Grayscale transverse fetal lung images were obtained at the level of the four-chamber heart. A region of interest was selected in each fetal lung image. Fetal lung HI was determined with MATLAB software using a dithering technique with ultrasound image pixels transformed into a binary map form from which a dynamic range value was determined. HI averages and standard deviations were generated for twin and singleton fetuses from 24 weeks gestation onward. Two sample t-tests were used to compare the mean HI at each gestational week between singleton and twin fetuses.
Results
In total, 388 singleton and 478 twin images were analyzed. From 35 through 38 weeks of gestation a statistically significant divergence in mean HI was observed with higher means in singleton compared to twin fetuses. At 24 weeks of gestation there was a significantly higher HI in twin fetuses compared to singletons. No differences in fetal lung HI were observed between 25 and 34 weeks gestational age.
Conclusions
Differences in fetal lung HI were observed when comparing twin and singleton fetuses. Further investigation is required to determine the potential clinical significance of these findings.
Acknowledgments
The authors would like to acknowledge the Registered Diagnostic Medical Sonographers for their image acquisition.
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Research ethics: The Northwell Health System Human Research Protection Program and Institutional Review Board approved this study protocol.
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Informed consent: Informed consent was obtained from all study participants.
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Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: The raw data can be obtained on request from the corresponding author.
References
1. Ghorayeb, SR, Bracero, LA, Blitz, MJ, Rahman, Z, Lesser, ML. Quantitative ultrasound texture analysis for differentiating preterm from term fetal lungs. J Ultrasound Med 2017;36:1437–43. https://doi.org/10.7863/ultra.16.06069.Suche in Google Scholar PubMed
2. Ward, C, Caughey, AB. Late preterm births: neonatal mortality and morbidity in twins and singletons. J Matern Fetal Neonatal Med 2021;35:7962–7. https://doi.org/10.1080/14767058.2021.1939303.Suche in Google Scholar PubMed
3. National Center for Health Statistics, Division of Vital Statistics. Natality public-use data 2016–2019. on CDC WONDER online database, 2020. Available from: http://wonder.cdc.gov/natality-expanded-curent.html [Accessed 9 Aug 2023].Suche in Google Scholar
© 2024 Walter de Gruyter GmbH, Berlin/Boston
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Artikel in diesem Heft
- Frontmatter
- Review
- Newborns at risk of COVID-19, the story continues
- Opinion Paper
- Why do women choose home births
- Original Articles – Obstetrics
- Association between aneuploidy screening analytes and adverse outcomes in twin gestations
- Vaginal matrix metalloproteinase-9 (MMP-9) as a potential early predictor of preterm birth
- Intrapartum pyrexia, cardiotocography traces and histologic chorioamnionitis: a case-control study
- Effect of maternal asthma on fetal pulmonary artery Doppler parameters: a case-control study
- Association of BDNF polymorphism with gestational diabetes mellitus risk: a novel insight into genetic predisposition
- Transvaginal three-dimensional ultrasound assessment of embryonic genital tubercle at 8–10+6 weeks of gestation
- Ultrasound prediction of fetal macrosomia in pregnancies complicated by diabetes mellitus: a systematic review and meta-analysis
- Comparative analysis of ultrasonographic fetal lung texture in twin and singleton fetuses
- Association between first-trimester uterine artery Doppler and crown-rump length with growth discordance: does it make a difference
- Original Articles – Fetus
- Evaluating fetal tricuspid and mitral annular plane systolic excursion (TAPSE and MAPSE) using spatiotemporal image correlation (STIC) M-mode
- Hepatic arterial buffer response in monochorionic twins with selective fetal growth restriction
- Original Articles – Neonates
- Increases in drug-related infant mortality in the United States
- Factors of poor prognosis in newborns with a prenatal diagnosis of gastroschisis in Bogota, Colombia
