Role of 3D Ultrasound for Assessment of Fetal Lungs

Abstract

Fetal lung maturity is vital to the survival rate of neonates, and is a determinant of extra uterine life. Neonatal respiratory distress syndrome and associated complications account for 28% of neonatal deaths. Although the wide use of glucocorticoids has decreased the incidence of Neonatal respiratory distress syndrome, approximately 10% of neonates still develop the syndrome. Accurate pre-delivery assessment of fetal lung maturity, especially in high-risk pregnancy, is critical to improving neonatal survival rate. Three types of tests are traditionally used to assess the degree of fetal lung maturity namely; the biochemical testing for surfactant components (e.g., Lecithin/ sphingomyelin ratio), biophysical testing for surfactant functionality (e.g., Foam stability index) or physical testing of the amniotic fluid opacity (e.g., lamellar body counts). All these tests involve the use of amniotic fluid (as it communicates directly with lung fluid), therefore, invasively and indirectly evaluate the probability of lung maturity. Moreover, they predict lung maturity more accurately than immaturity. Tests that directly assess fetal lung function are yet not available. With the innovation of 3-dimensional (3D) ultrasonography,