Three-dimensional ultrasound fetal lung volumes and infant respiratory outcome: a prospective observational study
Article first published online: 4 FEB 2011
© 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 118, Issue 5, pages 608–614, April 2011
How to Cite
Prendergast, M., Rafferty, G., Davenport, M., Persico, N., Jani, J., Nicolaides, K. and Greenough, A. (2011), Three-dimensional ultrasound fetal lung volumes and infant respiratory outcome: a prospective observational study. BJOG: An International Journal of Obstetrics & Gynaecology, 118: 608–614. doi: 10.1111/j.1471-0528.2010.02841.x
- Issue published online: 11 MAR 2011
- Article first published online: 4 FEB 2011
- Accepted 23 November 2010. Published Online 4 February 2011.
- Anterior wall defect;
- congenital diaphragmatic hernia;
- fetal lung volume;
- three-dimensional ultrasound
Please cite this paper as: Prendergast M, Rafferty G, Davenport M, Persico N, Jani J, Nicolaides K, Greenough A. Three-dimensional ultrasound fetal lung volumes and infant respiratory outcome: a prospective observational study. BJOG 2011;118:608–614.
Objective To determine if fetal lung volumes (FLVs), determined by three-dimensional rotational ultrasound and virtual organ computer-aided analysis software (vocal), correlated with neonatal respiratory outcomes in surviving infants who had a high risk [fetuses with congenital diaphragmatic hernia (CDH)], lower risk [fetuses with anterior wall defects (AWDs)] and no risk (controls) of abnormal antenatal lung growth.
Design Prospective observational study.
Setting Tertiary fetal medicine and neonatal intensive care units.
Population Sixty fetuses (25 with CDH, 25 with AWDs and ten controls).
Methods FLVs were measured and expressed as the percentage of the observed compared with the expected for gestational age.
Main outcome measures Neonatal respiratory outcome was determined by the duration of supplemental oxygen, mechanical ventilation and dependencies, and assessment of lung volume using a gas dilution technique to measure functional residual capacity (FRC).
Results The infants with CDH had lower FLV results than both the infants with AWDs (P = 0.05) and the controls (P < 0.05). The infants with CDH had longer durations of mechanical ventilation (P < 0.001) and supplementary oxygen (P < 0.001) dependence, compared with infants with AWDs. The infants with CDH had a lower median FRC than both the infants with AWDs (P < 0.001) and the controls (P < 0.001). FLV results correlated significantly with the durations of dependency on ventilation (r = −0.744, P < 0.01) and oxygen (r = −0.788, P < 0.001), and with FRC results (r = 0.429, P = 0.001).
Conclusions These results suggest that FLVs obtained using three-dimensional rotational ultrasound might be useful in predicting neonatal respiratory outcome in surviving infants who had varying risks of abnormal lung growth. Larger and more comprehensive studies are needed to clarify the role that lung volume measurements have in assessing lung function and growth.