title: Role of transabdominal ultrasound of lung bases and follow-up in premature neonates with respiratory distress soon after birth.
abstract: BACKGROUND
  Chest radiography has been the traditional method of diagnostic evaluation of patients of hyaline membrane disease (HMD). Lung sonography (USG) has been lately explored as an alternative modality.
  
  
  OBJECTIVE
  To explore the application of transabdominal USG of lung bases (TASL) in the evaluation of HMD in premature neonates with respiratory distress soon after birth.
  
  
  METHODS
  Tertiary care institutional setup. Study duration-18 months. Follow-up-variable, up to 1 month. Prospective descriptive study.
  
  
  METHODS
  Eighty-eight consecutive patients admitted in the neonatal intensive care unit (NICU) with gestational age <32 weeks having respiratory distress within 6 h of birth were enrolled. The diagnosis of HMD was made if the patient had negative gastric shake test and/or suggestive chest radiograph. TASL was performed in all patients within the first 24 h of life and biweekly subsequently. USG was interpreted as normal, HMD pattern, or broncho-pulmonary dysplasia (BPD) pattern. Biweekly follow-up was done for patients showing HMD till normalization of the sonographic HMD pattern, development of the sonographic BPD pattern, or death/discharge of the neonate from the hospital.
  
  
  CONCLUSIONS
  TASL showed 85.7% sensitivity, 75% specificity, 88.88% positive predictive value, and 69.2% negative predictive value for the diagnosis of HMD. The abnormal sonographic findings on day 14 had 94.1% accuracy for prediction of eventual occurrence of clinical BPD. TASL is complementary to chest radiograph in the diagnosis of HMD. It is also useful for the early prediction of BPD with the potential of reducing the cumulative radiation dose to these neonates.
authors.affiliation: Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Chirag Kamal
authors.initials: CK
authors.lastname: Ahuja
authors.forename: Akshay Kumar
authors.initials: AK
authors.lastname: Saxena
authors.forename: Kushaljeet Singh
authors.initials: KS
authors.lastname: Sodhi
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
keywords: Hyperechogenicity; neonates; respiratory distress syndrome; transabdominal; ultrasound