Quantitative Ultrasound Texture Analysis of Fetal Lung Versus Fetal Pulmonary Artery Doppler as a Predictor of Neonatal Respiratory Distress Syndrome (RDS)

Abstract

Purpose: To evaluate the role of fetal pulmonary artery Doppler indices and quantitative ultrasound texture analysis of the fetal lung (quantus FLM) in prediction of neonatal respiratory distress syndrome. Method: This Observational prospective cross sectional study included 40 pregnant women between 28 and 40 weeks gestation. The diagnostic accuracy of MPA Doppler measurements (pulsatility index (PI), resistance index (RI) and acceleration time/ejection time (AT/ET) for diagnosis of neonatal RDS was tested by comparing the Doppler findings with the clinical outcome. Results: Of the 40 eligible fetuses, 9 (22%) developed neonatal RDS There was a significant correlation between the AT/ET and the development of the RDS as the AT/ET was significantly lower in the RDS +ve group (mean 0.27) in comparison to the RDS-ve group (mean 0.34) (P 0.001). While both PI and RI showed no statistically significant difference in between the two groups. A cutoff value of 0.3 for AT/ET predicted the development of RDS (sensitivity: 77.78%, specificity: 83.87%). Quantus FLM predicted the development of neonatal RDS with high sensitivity, specificity, positive predictive value, negative predictive value and accuracy (88.98%, 90.32%, 72.7%, 96.6% and 90%respectively). The area under curve was 0.896. Conclusion: Neonatal RDS can be predicted using the MPA AT/ET and quantitative ultrasound texture analysis of the fetal lung (quantus FLM) with high sensitivity and specificity.