Predicting pulmonary hypoplasia with 2- or 3-dimensional ultrasonography in complicated pregnancies.
OBJECTIVE
The aim of this study was to compare 3-dimensional (3D) lung volume measurements with 2-dimensional (2D) biometric parameters in predicting pulmonary hypoplasia in complicated pregnancies.


METHODS
In this prospective study, 1-4 scans of the fetal lungs were obtained in 33 pregnancies complicated by various disorders or complications with regard to pulmonary hypoplasia. The 3D lung volumes vs gestational age or estimated fetal weight, the thoracic circumference vs gestational age or femur length, the thoracic/abdominal circumference ratio, and the thoracic/heart area ratio were measured.


RESULTS
Of the 33 infants, 16 (48.5%) were diagnosed with pulmonary hypoplasia on postmortem examination or the clinical and radiological presentation. Three dimensional lung volume measurements had a better diagnostic accuracy for predicting pulmonary hypoplasia (sensitivity, 94%; specificity, 82%; positive predictive value [PPV], 83%; negative predictive value [NPV], 93%), compared with the best 2D biometric measurement thoracic/heart area ratio (sensitivity, 94%; specificity, 47%; PPV, 63%; NPV, 89%).


CONCLUSIONS
3D lung volume measurements seem to be useful in predicting pulmonary hypoplasia prenatally.
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
D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D005325:Fetal Organ Maturity / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D021621:Imaging, Three-Dimensional; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging / Q000196:embryology*; D008176:Lung Volume Measurements; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler / Q000379:methods*; D016216:Ultrasonography, Prenatal / Q000379:methods*