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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

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Volume 46, Issue 2


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



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).


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−.


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.


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)


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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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