The Role of Fetal Pulmonary Artery Doppler in Prediction of Fetal Lung Maturity

Abstract

T he pulmonary system is considered the last fetal organ system required for extra uterine life to become functionally mature, and respiratory distress syndrome (RDS) related to pulmonary surfactant deficiency remains a major morbidity and mortality. Some preterm deliveries are sometimes provider initiated and others can be unintentionally preterm because of gestational age (GA) errors as commonly seen in women delivered by elective caesarean section (CS) Fetal lung maturity is the key factor for the survival of prematurely delivered newborn baby, therefore, knowledge of the fetal lung maturity is helpful to make the decision of continuation or termination of pregnancy. Determination of fetal lung maturity traditionally was relied on amniocentesis and measurement of proteins and lipid components in the amniotic fluid. This study was conducted with the participation of sixty pregnant women . Ultrasound scans were performed within 48 hours prior to delivery for pregnant women from 28 weeks to 40 weeks gestational age. The present study has shown that main pulmonary artery AT/ET ratio, fetal lung to liver echogenicity, free particles in amniotic fluid and placental grading were positively correlated with lung maturity. It identified main pulmonary artery AT/ET ratio (cutoff ≥ 0.30) with (92.3% sensitivity and 82.4% specificity), as reliable predictors of neonatal RDS. This means that fetuses who develop RDS have higher pulmonary vascular resistance, pressure, lower pulmonary blood flow and lower lung echogenicity compared with fetuses that do not develop RDS.