Acceleration/Ejection Time Ratio in the Fetal Pulmonary Artery Predicts Fetal Lung Maturity in Diabetic Pregnancies

Authors: Mohamed Ahmed Bahaa Eldin Mohamed, Hany Mohamed Ahmed EL-Didy, Ahmed Naguib Hosni, Hassan Mostafa Gaafar, Sherif Mohamed Alanwary


Abstract

To study the Doppler indices of the main fetal pulmonary artery, namely pulsatility index(PI), resistance index(RI), and the acceleration-time/ejection-time ratio(At/Et) and their role in predicting respiratory distress syndrome(RDS) in diabetic pregnancy.A prospective cohort study was developed, in which 40 diabetic pregnant women were selected, underwent 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 and correlated with the development of neonatal RDS. There was a direct correlation between the At/Et ratio in the fetal pulmonary artery velocimetry waveform and development of neonatal RDS. A cut off value of 0.31 provides Sensitivity=76.4% and Specificity=82.5% (positive predictive value=76.2% and negative predictive value=79.3%). An elevated At/Et ratio in the fetal pulmonary artery is associated with the subsequent development of RDS in neonates of diabetic mothers.

Keywords

Respiratory distress syndrome, fetal pulmonary artery lung velocity, doppler ultrasound, diabetes mellitus, apgar score

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Acceleration/Ejection Time Ratio in the Fetal Pulmonary Artery Predicts Fetal Lung Maturity in Diabetic Pregnancies