ABSTRACT
OBJECTIVE: The aim of this study was to compare 3-dimensional (3D) lung volume measurements with 2-dimensional (2D) biometric parameters in predicting pulmonary hypoplasia in complicated pregnancies. STUDY DESIGN: In this prospective study, 1-4 scans of the fetal lungs were obtained in 33 pregnancies complicated by various disorders or complications with regard to pulmonary hypoplasia. The 3D lung volumes vs gestational age or estimated fetal weight, the thoracic circumference vs gestational age or femur length, the thoracic/abdominal circumference ratio, and the thoracic/heart area ratio were measured. RESULTS: Of the 33 infants, 16 (48.5%) were diagnosed with pulmonary hypoplasia on postmortem examination or the clinical and radiological presentation. Three dimensional lung volume measurements had a better diagnostic accuracy for predicting pulmonary hypoplasia (sensitivity, 94%; specificity, 82%; positive predictive value [PPV], 83%; negative predictive value [NPV], 93%), compared with the best 2D biometric measurement thoracic/heart area ratio (sensitivity, 94%; specificity, 47%; PPV, 63%; NPV, 89%). CONCLUSION: 3D lung volume measurements seem to be useful in predicting pulmonary hypoplasia prenatally.
Subject(s)
Fetal Organ Maturity/physiology , Lung/embryology , Pregnancy, High-Risk , Ultrasonography, Doppler/methods , Ultrasonography, Prenatal/methods , Adult , Female , Fetal Diseases/diagnostic imaging , Gestational Age , Humans , Imaging, Three-Dimensional , Infant, Newborn , Lung/diagnostic imaging , Lung Volume Measurements , Predictive Value of Tests , Pregnancy , Pregnancy Outcome , Prospective Studies , Risk Factors , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
OBJECTIVES: The purpose of this study was to compare 3D lung volume measurements with 2D biometric parameters in predicting pulmonary hypoplasia in pregnancies complicated by preterm premature rupture of the membranes (PPROM). METHODS: In this prospective study, 18 pregnancies complicated by PPROMs at a mean 21 weeks' gestation (range 14-32 weeks) were examined. The 3D lung volume measurements and the following 2D biometric parameters were measured: thoracic circumference (TC) versus gestational age or femur length (FL), the TC/abdominal circumference (AC) ratio and the thoracic area/heart area (TA/HA) ratio. The sensitivity, specificity, positive and negative predictive value of each measurement to diagnose pulmonary hypoplasia were compared. Pulmonary hypoplasia was diagnosed on the basis of clinical, radiological and/or pathologic criteria. RESULTS: The incidence of pulmonary hypoplasia was 33.3%. The best diagnostic accuracy for predicting pulmonary hypoplasia was achieved using the 3D lung volume measurements versus gestational age (sensitivity 83%, specificity 100%, positive predictive value 100% and negative predictive value 92%). CONCLUSIONS: Three-dimensional lung volume measurements seem to be promising in predicting pulmonary hypoplasia prenatally in pregnancies complicated by PPROM.
Subject(s)
Fetal Membranes, Premature Rupture/diagnostic imaging , Lung/abnormalities , Lung/diagnostic imaging , Ultrasonography, Prenatal , Anthropometry , Birth Weight , Female , Fetal Membranes, Premature Rupture/mortality , Gestational Age , Humans , Imaging, Three-Dimensional , Infant, Newborn , Infant, Premature , Lung/embryology , Lung Volume Measurements , Pregnancy , Pregnancy Outcome , Prospective Studies , Sensitivity and SpecificityABSTRACT
OBJECTIVE: To describe the cases of 2 fetuses with aneurysms of the vein of Galen diagnosed prenatally. METHODS: The techniques used were conventional sonography, three-dimensional sonography, and ultrafast magnetic resonance imaging. On the basis of these imaging modalities, prognostic factors, such as drainage and secondary damage, were assessed. RESULTS: The first fetus had good prognostic indices, and embolization after birth was successful. According to the prognostic factors, a poor neonatal outcome was predicted for the second fetus. The neonate died soon after birth. CONCLUSIONS: Conventional sonography, color Doppler imaging, and magnetic resonance imaging appeared to be useful diagnostic tools. The prognostic factors can be useful in counseling patients and providing the best possible care after birth.
