Acceleration/ejection time ratio in the fetal pulmonary artery predicts fetal lung maturity

Am J Obstet Gynecol. 2010 Jul;203(1):40.e1-8. doi: 10.1016/j.ajog.2010.01.075. Epub 2010 Apr 24.

Abstract

Objective: The aim of this study was to determine whether sonographic fetal pulmonary artery flow velocity waveforms correlate with amniotic fluid biomarkers of fetal lung maturity.

Study design: We studied women with singleton pregnancies undergoing clinically indicated amniocentesis for fetal lung maturity at Yale-New Haven Hospital. Fetal pulmonary artery flow velocity measurements, including systolic/diastolic ratio, pulsatility index, resistance index, and acceleration-time/ejection-time ratio were obtained using spectral Doppler ultrasound. Pearson's correlation coefficient was used to determine the association between fetal pulmonary artery flow velocity parameters and the lecithin/sphingomyelin ratio.

Results: Twenty-nine subjects met study criteria. The acceleration-time/ejection-time ratio was inversely correlated with the lecithin/sphingomyelin ratio (r = -0.76; P < or = .001). This relationship was maintained after controlling for potential confounders. Other fetal pulmonary artery flow velocity measurements were not associated with the lecithin/sphingomyelin ratio.

Conclusion: There is an inverse correlation between the acceleration-time/ejection-time ratio in the fetal pulmonary artery and the amniotic fluid lecithin/sphingomyelin ratio. This suggests that ultrasound evaluation of fetal pulmonary artery blood flow may be a promising new noninvasive technique to evaluate fetal lung maturity.

MeSH terms

  • Adult
  • Amniotic Fluid / metabolism
  • Blood Flow Velocity / physiology
  • Cohort Studies
  • Female
  • Fetal Organ Maturity / physiology*
  • Fetus
  • Humans
  • Infant, Newborn
  • Lung / blood supply
  • Lung / diagnostic imaging*
  • Lung / physiology
  • Male
  • Phosphatidylcholines / metabolism
  • Pregnancy
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Artery / embryology
  • Respiratory Distress Syndrome, Newborn / diagnostic imaging*
  • Respiratory Distress Syndrome, Newborn / metabolism
  • Sphingomyelins / metabolism
  • Statistics, Nonparametric
  • Ultrasonography, Prenatal / methods*

Substances

  • Phosphatidylcholines
  • Sphingomyelins