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Doppler US predicts fetal pulmonary hypoplasia. (Measuring Physiologic Changes).
NEW ORLEANS -- Doppler ultrasound can accurately predict fetal pulmonary hypoplasia by measuring changes in blood flow before and after maternal hyperoxygenation, Dr. Richard Broth said at the annual meeting of the Society for Maternal-Fetal Medicine.
In a study of 28 fetuses suspected to be at risk for pulmonary hypoplasia, a reactive Doppler ultrasound test was 93% accurate in predicting neonatal survival. A nonreactive test--one in which no changes in fetal blood flow, waveforms, and pulsatility indices were documented--was 79% accurate in predicting neonatal death, he said.
"Our hypothesis was that a fetus with lethal pulmonary hypoplasia would have no change from the room air baseline in the Doppler flow pattern in a branched pulmonary artery after maternal hyperoxygenation," said Dr. Broth, a fellow in maternal-fetal medicine at Jefferson Medical College, Philadelphia.
The study protocol involved baseline assessment of fetal pulmonary circulation, following which 60% oxygen was administered by rebreathing mask to the mothers. Changes in circulation were observed, and pulsatility indices were calculated.
A total of 14 of the tests were nonreactive; the remaining 14 were reactive. One was a false negative; this was a case of congenital cystic adenomatous malformation. There were three false positives-fetuses that were not expected to survive but did so. Two of these continue to have significant pulmonary problems.
The third false positive was an infant delivered within 2 hours of the test because of severe placental insufficiency relating to intrauterine growth restriction and redistribution of the cardiac output.
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Source: HighBeam Research, Doppler US predicts fetal pulmonary hypoplasia. (Measuring...