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Prenatal prediction of respiratory distress syndrome by multimodality approach using 3D lung ultrasound, lung-to-liver intensity ratio tissue histogram and pulmonary artery Doppler assessment of fetal lung maturity
Open accessAbstract
Objective: Studying the correlation of different lung parameters, using three-dimensional ultrasound (3D US) with fetal lung maturity (FLM) to predict the development of neonatal respiratory distress syndrome (RDS). Methods: Three-dimensional ultrasound was done to record the fetal lung volume (FLV), fetal lung-to-liver intensity ratio (FLLIR) and the main pulmonary artery (MPA) blood flow parameters; pulsatility index (PI), resistive index (RI) and acceleration time-to-ejection time ratio (At/Et), to 218 women between 32 and 40 weeks gestational age within 24 h from labor. Results: Of 218 fetuses examined, final analysis was done for 143 fetuses. Thirty eight (26.5%) were diagnosed with RDS. The MPA PI and RI were significantly higher in fetuses diagnosed with RDS compared with those without (2.51 ± 0.33 and 0.90 ± 0.03 cm/s versus 1.96 ± 0.20 and 0.84 ± 0.01 cm/s; p value < 0.001 and <0.001 respectively). MPA At/Et was significantly lower (0.24 ± 0.04 vs 0.35 ± 0.04; p value < 0.001). FLLIR was significantly lower (1.04 ± 0.07 vs 1.18 ± 0.11; p value < 0.001), and the mean FLV was significantly smaller (28.23 ± 5.63, vs 38.87 ± 4.68 cm3; p value < 0.001). Conclusion: Main pulmonary artery (PI, RI, At/Et ratio), FLIIR, and mean FLV can be used as reliable predictors of neonatal RDS. Advances in knowledge: 3D ultrasound VOCAL technique, ultrasound tissue histogram and pulmonary artery Doppler are reliable tools for prenatal prediction of fetal lung maturity.
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“Third, by integrating serial multimodal features with dynamic metabolomic scores, the dosing branch predicted individualized GC regimens with sub-milligram precision, outperforming static gestational age-based protocols (12 mg × 2) that neglect inter-individual variation (19, 20).”
From Placenta-pulmonary coupling-guided multimodal AI for fetal lung maturity staging and individualized glucocorticoid therapy (2026) · cites this paper as [19]
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References 37 · Cited by 20
Research works printed but not linked: 2
- Liu J, 2013, Zhong Hua Er Ke Za Zhi, 51, 205
- Loret de Mola JR, 1998, J Reprod Med, 43, 898
Metadata
- Authors
- Khalifa, Y. E. A., Aboulghar, M. M., Hamed, S. T., Tomerak, R. H., Asfour, A. M., & Kamal, E. F.
- Affiliations
- Cairo University (EG)
- Venue
- The British Journal of Radiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-12
- Volume
- 94
- Issue
- 1128
- Pages
- 20210577-20210577
- ISSN
- 0007-1285 (ISSN-L)
- 1748-880X
- PMC
- PMC8631030
- OpenAlex
- W3201595245
- Cited by
- 20
- References
- 37
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 2
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Radiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Health Sciences › Medicine › Surgery › Congenital Diaphragmatic Hernia Studies
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Ultrasound in Clinical Applications
- Keywords
- neonatal respiratory distress syndrome, fetal lung maturity, prenatal prediction, pulsatility index, resistance index, fetal lung volume, vocal technique
- MeSH terms
- Adolescent, Adult, Cross-Sectional Studies, Female, Humans, Liver, Lung, Predictive Value of Tests, Pregnancy, Prospective Studies, Pulmonary Artery, Respiratory Distress Syndrome, Newborn, Ultrasonography, Prenatal, Ultrasonography, Doppler, Imaging, Three-Dimensional, Young Adult
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- CoChat. (2026). Citation check: Prenatal prediction of respiratory distress syndrome by multimodality approach using 3D lung ultrasound, lung-to-liver intensity ratio tissue histogram and pulmonary artery Doppler assessment of fetal lung maturity. https://app.cochat.ai/papers/10.1259/bjr.20210577
- The paper
- Khalifa, Y. E. A., Aboulghar, M. M., Hamed, S. T., Tomerak, R. H., Asfour, A. M., & Kamal, E. F. (2021). Prenatal prediction of respiratory distress syndrome by multimodality approach using 3D lung ultrasound, lung-to-liver intensity ratio tissue histogram and pulmonary artery Doppler assessment of fetal lung maturity. The British Journal of Radiology. https://doi.org/10.1259/bjr.20210577
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