Fetal Main Pulmonary Artery Doppler and Lamellar Body Count in Amniotic Fluid as Predictors for Respiratory Distress Syndrome Development

Salama, Heba Farag Mohamed; Emaraa, Mohamed Abdelghani; Serag, Dena Mamdouh; Sorial, Kerolos Usama Henry; Rawash, Mohamed Sabry Ahmed

doi:10.21608/egyfs.2025.431333

Fetal Main Pulmonary Artery Doppler and Lamellar Body Count in Amniotic Fluid as Predictors for Respiratory Distress Syndrome Development

Document Type : Original Article

Authors

¹ Ass. Prof. of Obstetrics and Gynecology, Menouﬁa University,

² Prof. of Obstetrics and Gynecology, Menouﬁa University

³ Ass. Prof. of Diagnostic and Interventional Radiology, Medical Imaging, Menouﬁa University

⁴ Ob/Gyn Resident Doctor at EL-Tahrir General Hospital Imbaba

⁵ Lecturer of Obstetrics and Gynecology, Menouﬁa University

10.21608/egyfs.2025.431333

Abstract

Context: Insufﬁcient surfactant in the underdeveloped fetal lungs can cause severe respiratory distress syndrome (RDS), potentially necessitating specialized management during delivery.
Aims: Investigate the lamellar body count in amniotic ﬂuid and fetal main pulmonary artery doppler measures as possible markers for the onset of respiratory distress syndrome.
Settings and Design: This cross-sectional study included 118 pregnant women scheduled for elective Cesarean sec-tion. Participants were recruited from Menouﬁa Univer-sity Hospital and El-Tahrir General Hospital in Imbaba.
Methods and Material: All the studied cases were sub-jected to: Detailed personal and obstetric histories in-cluded information such as:(Age, BMI, Sex, Gravidity, Parity, Gestational age, Previous CS, Previous PTL, Cor-ticosteroids and Corticosteroids dose time), Ultrasound Examinations, Cesarean section and delivery assessment, Post-Delivery Neonatal Evaluation.
Statistical analysis used: Data analysis was conducted using SPSS version 24, which stands for the Statistical Program for the Social Sciences.
Results: Patients with respiratory distress syndrome (RDS) can be reliably identiﬁed using the pulmonary ar-tery pulsatility index (PI) when the cut off value is more than 2.55. It shows 81.8% sensitivity, 100% speciﬁcity, 100% positive predictive value (PPV), and 98.2% nega-tive predictive value (NPV) with an area under the curve (AUC) of 0.96 and a p-value less than 0.001. Also, with a cutoff value higher than 0.89, the pulmonary artery resis-tance index (RI) can distinguish RDS in these patients. It has a 0.9 area under the curve (AUC) and a p-value of less than 0.001, in addition to 81.8% sensitivity, 85% speciﬁc-ity, 36% PPV, and 97.8% NPV.
Conclusions: A fetal main pulmonary artery Doppler measurement, an amniotic ﬂuid lamellar body count (LBC) and pulmonary artery index can be used to an-ticipate neonatal respiratory distress syndrome (RDS). In conjunction with lower LBC and higher Pulmonary Artery Pulsatility Index (PI) and Resistance Index (RI), these non-invasive methods of fetal lung maturity evaluation are very helpful in assessing the risk of RDS.

Keywords