Lung Volume Head Ratio: A Potential Parameter for Prediction of Respiratory Distress in Newborn

Abstract

Objective This study aimed to evaluate the role of fetal lung biometry profile including fetal lung volume head ratio (LVHR) in predicting the occurrence of respiratory distress (RD) in early preterm newborn.

Study Design Prospective analytical cohort study was done to evaluate the clinical value of fetal sonographic measures, such as the total lung area (TLA), total lung volume (TLV), TLA head ratio (TLHR), LVHR, in pregnant women between 30 to 34 weeks' gestation who were expected to deliver within the next 72 hours. The cases with RD were compared with controls who had normal outcome.

Result A total of 30 (27.4%) out of 110 patients, who underwent early preterm delivery, with RD rest 80 (72.6%) were controls. The TLA was 694.1 ± 373.1 mm² in cases whereas 1,149.0 ± 506 0.7 mm² in controls with significant difference between the two groups (p < 0.001). Similarly the lung volume (p < 0.001) and the LVHR were significantly less (p < 0.001) in cases compared with controls. The TLV was a better parameter (sensitivity, 73.7% and specificity, 86.4%) compared with TLA (sensitivity, 68.4% and specificity, 81.5%). Among the lung head ratios, LVHR had the best sensitivity of 95.5%, specificity: 80.3%, positive predictive value (PPV): 58.3%, and negative predictive value (NPV): 97.0% at the cut-off of 46.5.

Conclusion RD was observed in nearly one-third of the preterm infants born between 30 and 34 weeks of gestation and could be predicted accurately in over 9 out of 10 cases using the novel parameter TLVR.

Key Points

• Preterm newborn.

• Fetal lung volume.

• Respiratory distress.

Keywords

fetal lung volume - total lung area - respiratory distress - Apgar's score - early preterm - lung head ratio

Data Availability Statement

The data that support the findings of this study are available from the corresponding author on reasonable request.

Publikationsverlauf

Eingereicht: 29. Mai 2021

Angenommen: 13. September 2021

Accepted Manuscript online:
20. September 2021

Artikel online veröffentlicht:
08. November 2021

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