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Prediction of neonatal respiratory distress in pregnancies complicated by fetal lung masses.

CPQCC Publication
TitlePrediction of neonatal respiratory distress in pregnancies complicated by fetal lung masses.
Publication TypeJournal Article
Year of Publication2017
AuthorsGirsen AI, Hintz SR, Sammour R, Naqvi A, El-Sayed YY, Sherwin K, Davis AS, Chock VY, Barth RA, Rubesova E, Sylvester KG, Chitkara R, Blumenfeld YJ
JournalPrenat Diagn
Date Published2017 Mar
KeywordsFemale, Fetal Diseases, Fetus, Gestational Age, Humans, Infant, Newborn, Lung, Lung Diseases, Magnetic Resonance Imaging, Organ Size, Predictive Value of Tests, Pregnancy, Prognosis, Respiratory Distress Syndrome, Newborn, Retrospective Studies, Sensitivity and Specificity, Ultrasonography, Prenatal

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 by MRI (100% sensitivity, 91% specificity, 60% positive predictive value, and 100% negative predictive value) and maximal volume >34.0 cm 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.

Alternate JournalPrenat Diagn
PubMed ID28061000