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Sonographic evaluation of vascular pulmonary reactivity following oxygen administration in fetuses with normal lung development

Authors


  • Funding sources: The following organizations support the fetal medicine research programs of the University Hospitals Leuven: Fonds voor Wetenschappelijk Onderzoek Vlaanderen (FWO; 1.8.012.07.N.02) and Instituut voor Wetenschap en Technologie (IWT/070715). P. D. K. is a recipient of an Industria-Academia Partnership Marie Curie Grant of the European Commission (www.endovv.com; PIAP-GA-2009-251356).
  • Conflicts of Interest: None declared

Jan A. Deprest. E-mail: jan.deprest@uzleuven.be

ABSTRACT

Objective

This study aimed to establish nomograms for sonographic assessment of fetal pulmonary vascular reactivity following maternal hyperoxygenation.

Study design

Sixty-two healthy fetuses were assessed at four weekly intervals from 26 weeks onwards. Pulmonary reactivity was evaluated using Doppler ultrasound in the main pulmonary artery and in the first branch of this main pulmonary artery. The difference in pulsatility index (∆PI) during maternal inhalation of a mixture of room air and oxygen (9 L/min) for at least 10 min was expressed as a percentage. Nomograms were constructed, and Kaplan–Meier curves were used to express the occurrence of a reactive test (∆PI ≥ 20%) with advancing gestation.

Results

In the first branch, linear regression analysis revealed a significant correlation of ∆PI (%) with gestational age (r2 = 0.04, p = 0.0057). Large inter-individual and intra-individual variability was noted. The ∆PI (%) in the main pulmonary artery remained constant throughout gestation (6.62 ± 17.83%).

Conclusion

Vascular reactivity in the pulmonary circulation increases in the first branch of the pulmonary artery. Large individual variability is limiting its use as a management tool. © 2012 John Wiley & Sons, Ltd.

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