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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica


IMPACT FACTOR 2018: 1.361
5-year IMPACT FACTOR: 1.578

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1619-3997
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Volume 46, Issue 2

Issues

A non-invasive method to rule out transient tachypnea of the newborn (TTN): fetal pulmonary artery acceleration to ejection time ratio

Barış Büke
  • Department of Obstetrics and Gynecology, Kayseri Training and Research Hospital, Kayseri, Turkey
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Hatice AkkayaORCID iD: http://orcid.org/0000-0002-9613-1712
Published Online: 2017-03-27 | DOI: https://doi.org/10.1515/jpm-2016-0380

Abstract

Objective:

To investigate whether fetal pulmonary artery acceleration to ejection time (PATET) ratio can predict or rule out subsequent diagnosis of transient tachypnea of the newborn (TTN).

Methods:

This prospective cohort study included 105 pregnant women in labor, who met the inclusion criteria. Eighteen of these women were removed from the study cohort, because of an inability to acquire sufficient Doppler waveforms and a longer duration of deliveries. According to subsequent diagnosis of TTN in the neonate, the two groups were constituted, TTN+ and TTN−.

Results:

There were no statistically significant differences between the groups regarding maternal obstetric and demographic features. The neonatal intensive care unit (NICU) submission rate was significantly higher in the TTN+ group (100%, 17%, P<0.0001, respectively). Regarding the fetal pulmonary artery Doppler findings, PATET ratio in the TTN+ group was significantly lower than the TTN− group (0.307 vs. 0.389, P<0.0001, respectively). The PATET ratio and diagnosis of TTN were inversely correlated (r=−0.41, P<0.001), even if adjusted for birth weight, gestational age and fetal gender (r=0.42, P=0.0021). The cut-off value of 0.319 provided 82.7% specificity, 83.3% sensitivity, 96% negative predictive value and 41.6% positive predictive value. Additionally intraobserver ICC for PATET was found to be 0.86.

Conclusion:

The fetal PATET ratio seems to serve as a promising tool to rule out subsequent diagnosis of TTN.

Keywords: Fetal pulmonary artery acceleration to ejection time (PATET) ratio; fetal pulmonary artery Doppler indices; non-invasive method; transient tachypnea of the newborn (TTN)

References

  • [1]

    Guglani L, Lakshminrusimha S, Ryan RM. Transient tachypnea of the newborn. Pediatr Rev. 2008;29:e59–65.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [2]

    Demirel G, Uras N, Celik IH, Canpolat FE, Dilmen U. Nasal intermittent mandatory ventilation versus nasal continuous positive airway pressure for transient tachypnea of newborn: a randomized, prospective study. J Matern Fetal Neonatal Med. 2013;26:1099–102.CrossrefWeb of SciencePubMedGoogle Scholar

  • [3]

    Avery ME, Gatewood OB, Brumley G. Transient tachypnea of newborn: possible delayed resorption of fluid at birth. Am J Dis Child. 1966;111:380–5.CrossrefPubMedGoogle Scholar

  • [4]

    Tudehope D, Smyth MH. Is “transient tachypnoea of the newborn” always a benign disease? Report of 6 babies requiring mechanical ventilation. J Paediatr Child Health. 1979;15:160–5.CrossrefGoogle Scholar

  • [5]

    Kugelman A, Riskin A, Weinger‐Abend M, Bader D. Familial neonatal pneumothorax associated with transient tachypnea of the newborn. Pediatr Pulmonol. 2003;36:69–72.CrossrefPubMedGoogle Scholar

  • [6]

    Rasanen J, Huhta JC, Weiner S, Wood DC, Ludomirski A. Fetal branch pulmonary arterial vascular impedance during the second half of pregnancy. Am J Obstet Gynecol. 1996;174:1441–9.CrossrefPubMedGoogle Scholar

  • [7]

    Chaoui R, Taddei F, Rizzo G, Bast C, Lenz F, Bollmann R. Doppler echocardiography of the main stems of the pulmonary arteries in the normal human fetus. Ultrasound Obstet Gynecol. 1998;11:173–9.PubMedCrossrefGoogle Scholar

  • [8]

    Kitabatake A, Inoue M, Asao M, Masuyama T, Tanouchi J, Morita T, et al. Noninvasive evaluation of pulmonary hypertension by a pulsed Doppler technique. Circulation. 1983;68:302–9.CrossrefPubMedGoogle Scholar

  • [9]

    Mitchell J, Roberts A, Lee A. Doppler waveforms from the pulmonary arterial system in normal fetuses and those with pulmonary hypoplasia. Ultrasound Obstet Gynecol. 1998;11:167–72.CrossrefPubMedGoogle Scholar

  • [10]

    Chaoui R, Kalache K, Tennstedt C, Lenz F, Vogel M. Pulmonary arterial Doppler velocimetry in fetuses with lung hypoplasia. Eur J Obstet Gynecol Reprod Biol. 1999;84:179–85.CrossrefPubMedGoogle Scholar

  • [11]

    Kim SM, Park JS, Norwitz ER, Hwang EJ, Kang HS, Park C-W, et al. Acceleration time-to-ejection time ratio in fetal pulmonary artery predicts the development of neonatal respiratory distress syndrome: a prospective cohort study. Am J Perinatol. 2013;30:805–12.CrossrefWeb of SciencePubMedGoogle Scholar

  • [12]

    Guan Y, Li S, Luo G, Wang C, Norwitz ER, Fu Q, et al. The role of Doppler waveforms in the fetal main pulmonary artery in the prediction of neonatal respiratory distress syndrome. J Clin Ultrasound. 2015;43:375–83.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [13]

    Rizzo G, Capponi A, Angelini E, Mazzoleni A, Romanini C. Blood flow velocity waveforms from fetal peripheral pulmonary arteries in pregnancies with preterm premature rupture of the membranes: relationship with pulmonary hypoplasia. Ultrasound Obstet Gynecol. 2000;15:98–103.PubMedCrossrefGoogle Scholar

  • [14]

    Rawlings JS, Smith FR. Transient tachypnea of the newborn: an analysis of neonatal and obstetric risk factors. Am J Dis Child. 1984;138:869–71.CrossrefPubMedGoogle Scholar

  • [15]

    Clark SL, Meyers JA, Perlin JB. Oversight of elective early term deliveries: avoiding unintended consequences. Am J Obstet Gynecol. 2012;206:387–9.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [16]

    Martin JA, Hamilton BE, Osterman M, Curtin SC, Matthews T. Births: final data for 2013. Natl Vital Stat Rep. 2015;64:1–65.PubMedGoogle Scholar

  • [17]

    Statland BE, Sher G, Freer DE, Kraybill EN, Smith HY, Hisley JC. Evaluation of a modified foam stability (FS-50) test: an assay performed on amniotic fluid to predict fetal pulmonary maturity. Am J Clin Pathol. 1978;69:514–9.CrossrefPubMedGoogle Scholar

  • [18]

    Hagen E, Link JC, Arias F. A comparison of the accuracy of the TDx-FLM assay, lecithin-sphingomyelin ratio, and phosphatidylglycerol in the prediction of neonatal respiratory distress syndrome. Obstet Gynecol. 1993;82:1004–8.PubMedGoogle Scholar

  • [19]

    Tsuda H, Takahashi Y, Iwagaki S, Uchida Y, Kawabata I, Hayakawa M, et al. Amniotic lamellar body counts can predict the occurrence of respiratory distress syndrome as well as transient tachypnea of the newborn (TTN). J Perinat Med. 2011;39:245–50.Web of SciencePubMedGoogle Scholar

  • [20]

    Machado M, Chita S, Allan L. Acceleration time in the aorta and pulmonary artery measured by Doppler echocardiography in the midtrimester normal human fetus. Br Heart J. 1987;58:15–8.CrossrefPubMedGoogle Scholar

  • [21]

    Laudy J, Gaillard J, Anker J, Tibboel D, Wladimiroff J. Doppler ultrasound imaging: a new technique to detect lung hypoplasia before birth? Ultrasound Obstet Gynecol. 1996;7:189–92.Google Scholar

  • [22]

    Azpurua H, Norwitz ER, Campbell KH, Funai EF, Pettker CM, Kleine M, et al. Acceleration/ejection time ratio in the fetal pulmonary artery predicts fetal lung maturity. Am J Obstet Gynecol. 2010;203:40.e1–8.CrossrefWeb of ScienceGoogle Scholar

  • [23]

    Schenone MH, Samson JE, Jenkins L, Suhag A, Mari G. Predicting fetal lung maturity using the fetal pulmonary artery Doppler wave acceleration/ejection time ratio. Fetal Diagn Ther. 2014;36:208–14.Web of SciencePubMedCrossrefGoogle Scholar

About the article

Corresponding author: Hatice Akkaya, MD, Department of Obstetrics and Gynecology, Kayseri Training and Research Hospital, Kayseri, Turkey, Tel.: 903523368884


Received: 2016-11-26

Accepted: 2017-02-20

Published Online: 2017-03-27

Published in Print: 2018-02-23


Author’s statement

Conflict of interest: All of the contributing authors declare no conflict of interest.

Material and methods

Informed consent: Informed consent has been obtained from all individuals included in this study.

Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.


Citation Information: Journal of Perinatal Medicine, Volume 46, Issue 2, Pages 219–224, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2016-0380.

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