PERINATOLOGIYA I PEDIATRIYA. 2014. 3(59):21-25; doi 10.15574/PP.2014.59.21 
 

An assessment of the degree of fetal lung hypoplasia with two-dimensional ultrasound

G.O. Grebinichenko, I.Yu. Gordienko, O.M. Tarapurova, O.K. Slepov, V.L. Veselskiy, O.V. Nidelchuk, A.O. Nosko, A.V. Velychko

Department of Fetal Medicine, State Institution «Institute of Pediatrics, Obstetrics and Gynecology, Academy of Medical Sciences of Ukraine», Kyiv, Ukraine

Purpose: to develop a method of diagnosis and assessment of pulmonary hypoplasia in fetus with two-dimensional ultrasound.

Patients and methods: an ultrasound examination is performed with a diagnostic scanner ACCUVIX V20EX-EXP. The lung measurement was held in 300 at 12–37 weeks of gestation periods of the normal pregnancy, normal development and an accordance size for gestational age. 12 fetuses had the pathology development with the left-sided cystic-adenomatous malformation of the lung and 21 fetuses with isolated left-sided congenital diaphragmatic hernia. The measurement was made with the cross-scan of the chest at the level of the heart valves (four-chamber section of the heart):determined the lung area with the method of outlining a continuous line (manual tracing). There were analyzed the lung area indicators counter-lateral to the side of the lesion.

Results: a size estimating of the counter-lateral lung in fetuses with cystic-adenomatous malformation of the lung showed that the average degree of hypoplasia was at 33.30% of cases, the rest one had the easy degree hypoplasia (50.00%) or the normal sizes of the counter-lateral lung; with the left-sided congenital diaphragmatic hernia it was observed the greater defeat of the counter-lateral lung — the severe hypoplasia in 9.52% and moderate in 57.14% of cases.

Conclusion: the ratio of the measured fetal lung area to the specified index does not independent of the other dimensions of the fetus and the pregnancy, so the proposed correlation can be used to determine the degree of pulmonary hypoplasia with various pathologies and accompanied by the changes in the basic size of the fetus. Using the above method allows for the two-dimensional ultrasound to improve the diagnosis of pulmonary hypoplasia in the fetus and to determine its degree. It will give an opportunity to forecast the fetus development in pregnancy tactics, special care for the newborn and to improve the assessment and the scientific data processing of the patients who were examined at different stages of pregnancy.

Key words: fetal lung, pulmonary hypoplasia, ultrasound examination.

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