Two- or three-dimensional ultrasonography to predict pulmonary hypoplasia in pregnancies complicated by preterm premature rupture of the membranes.
OBJECTIVE
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.
Gerards
Franca A
FA
Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands. fa.gerards@vumc.nl
Twisk
Jos W R
JW
Fetter
Willem P F
WP
Wijnaendts
Liliane C D
LC
Van Vugt
John M G
JM
D000886:Anthropometry; D001724:Birth Weight; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000000981:diagnostic imaging* / Q000401:mortality; D005865:Gestational Age; D006801:Humans; D021621:Imaging, Three-Dimensional; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000196:embryology; D008176:Lung Volume Measurements; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal