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Rabachini Caetano AC, Machado Nardozza LM, Perez Zamarian AC, Silva Drumond LG, Chiaratti de Oliveira A, Dualib PM, Araujo Júnior E, Mattar R. Prediction of lung maturity through quantitative ultrasound analysis of fetal lung texture in women with diabetes during pregnancy. J Perinat Med 2023; 51:913-919. [PMID: 37097317 DOI: 10.1515/jpm-2023-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/01/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVES The present study aimed to evaluate the performance of QuantusFLM® software, which performs quantitative ultrasound analysis of fetal lung texture, in predicting lung maturity in fetuses of diabetic mothers. METHODS The patients included in this study were between 34 and 38 weeks and 6 days gestation and were divided into two groups: (1) patients with diabetes on medication and (2) control. The ultrasound images were performed up to 48 h prior to delivery and analyzed using QuantusFLM® software, which classified each fetus as high or low risk for neonatal respiratory morbidity based on lung maturity or immaturity. RESULTS A total of 111 patients were included in the study, being 55 in diabetes and 56 in control group. The pregnant women with diabetes had significantly higher body mass index (27.8 kg/m2 vs. 25.9 kg/m2, respectively, p=0.02), increased birth weight (3,135 g vs. 2,887 g, respectively, p=0.002), and a higher rate of labor induction (63.6 vs. 30.4 %, respectively, p<0.001) compared to the control group. QuantusFLM® software was able to predict lung maturity in diabetes group with 96.4 % accuracy, 96.4 % sensitivity and 100 % positive predictive value. Considering the total number of patients, the software demonstrated accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 95.5 , 97.2, 33.3, 98.1 and 25 %, respectively. CONCLUSIONS QuantusFLM® was an accurate method for predicting lung maturity in normal and DM singleton pregnancies and has the potential to aid in deciding the timing of delivery for pregnant women with DM.
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Affiliation(s)
- Ana Carolina Rabachini Caetano
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
- Fetal Medicine Unit, Department of Perinatology, Albert Einstein Hospital, São Paulo, SP, Brazil
| | | | - Ana Cristina Perez Zamarian
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
| | - Luiza Grosso Silva Drumond
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
| | - Allan Chiaratti de Oliveira
- Department of Pediatrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
| | - Patricia Medici Dualib
- Department of Medical Clinic, Discipline of Endocrinology, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
| | - Rosiane Mattar
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
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Moreno-Espinosa AL, Hawkins-Villarreal A, Coronado-Gutierrez D, Burgos-Artizzu XP, Martínez-Portilla RJ, Peña-Ramirez T, Gallo DM, Hansson SR, Gratacòs E, Palacio M. Prediction of Neonatal Respiratory Morbidity Assessed by Quantitative Ultrasound Lung Texture Analysis in Twin Pregnancies. J Clin Med 2022; 11:jcm11164895. [PMID: 36013134 PMCID: PMC9409975 DOI: 10.3390/jcm11164895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 07/27/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to evaluate the performance of quantitative ultrasound of fetal lung texture analysis in predicting neonatal respiratory morbidity (NRM) in twin pregnancies. This was an ambispective study involving consecutive cases. Eligible cases included twin pregnancies between 27.0 and 38.6 weeks of gestation, for which an ultrasound image of the fetal thorax was obtained within 48 h of delivery. Images were analyzed using quantusFLM® version 3.0. The primary outcome of this study was neonatal respiratory morbidity, defined as the occurrence of either transient tachypnea of the newborn or respiratory distress syndrome. The performance of quantusFLM® in predicting NRM was analyzed by matching quantitative ultrasound analysis and clinical outcomes. This study included 166 images. Neonatal respiratory morbidity occurred in 12.7% of cases, and it was predicted by quantusFLM® analysis with an overall sensitivity of 42.9%, specificity of 95.9%, positive predictive value of 60%, and negative predictive value of 92.1%. The accuracy was 89.2%, with a positive likelihood ratio of 10.4, and a negative likelihood ratio of 0.6. The results of this study demonstrate the good prediction capability of NRM in twin pregnancies using a non-invasive lung texture analysis software. The test showed an overall good performance with high specificity, negative predictive value, and accuracy.
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Affiliation(s)
- Ana L. Moreno-Espinosa
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08028 Barcelona, Spain
- Department of Obstetrics and Gynecology, Hospital Santo Tomás, Universidad de Panamá, Panama City 07096, Panama
- Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City 06720, Mexico
- Correspondence: ; Tel.: +34-932-27-54-00 (ext. 7281)
| | - Ameth Hawkins-Villarreal
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08028 Barcelona, Spain
- Department of Obstetrics and Gynecology, Hospital Santo Tomás, Universidad de Panamá, Panama City 07096, Panama
- Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City 06720, Mexico
| | - David Coronado-Gutierrez
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08028 Barcelona, Spain
- Transmural Biotech SL, 08021 Barcelona, Spain
| | - Xavier P. Burgos-Artizzu
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08028 Barcelona, Spain
- Transmural Biotech SL, 08021 Barcelona, Spain
| | - Raigam J. Martínez-Portilla
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08028 Barcelona, Spain
- Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City 06720, Mexico
- Clinical Research Branch, National Institute of Perinatology, Mexico City 11000, Mexico
| | - Tatiana Peña-Ramirez
- School of Medicine, Universidad del Valle, Cali 760032, Colombia
- Department of Obstetrics and Gynecology, Hospital Universitario del Valle Evaristo García E.S.E., Cali 760043, Colombia
| | - Dahiana M. Gallo
- School of Medicine, Universidad del Valle, Cali 760032, Colombia
- Department of Obstetrics and Gynecology, Hospital Universitario del Valle Evaristo García E.S.E., Cali 760043, Colombia
| | - Stefan R. Hansson
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences Lund, Lund University, 221 00 Lund, Sweden
- Skåne University Hospital, 214 28 Malmö, Sweden
| | - Eduard Gratacòs
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08028 Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBERER), 28029 Madrid, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, 08036 Barcelona, Spain
| | - Montse Palacio
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08028 Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBERER), 28029 Madrid, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, 08036 Barcelona, Spain
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