Prediction of Fetal Lung Maturity in Diabetic Women by Pulmonary Artery Doppler study (Controlled Clinical Trial)

Objective: The goal of this controlled clinical experiment was to use pulmonary artery Doppler to predict foetal lung maturity in diabetic pregnant women having elective uncomplicated caesarean sections.
Materials and Methods: From September 2017 to March 2018, the study was carried out at the Ain Shams University Maternity Hospital's Faculty of Medicine. This research, which included 80 patients who were ready to undergo foetal pulmonary artery Doppler ultrasonography, was divided into two groups as follows: 40 pregnant women with managed diabetes mellitus made up the case group. A total of 40 pregnant women without diabetes mellitus complications made up the (control group). The proximal part of the main pulmonary artery is where the measurements of the foetal pulmonary artery flow waveform (FPAF) were made. The FPAF waveform (average values of 3 waves) was used to quantify the systolic/diastolic ratio, pulsatility index (PI), resistance index (RI), and acceleration time/ejection time ratio (At/Et). With the same U/S equipment, a senior single sonographer completed all measurements. Senior neonatologists performed infant resuscitation and evaluation after birth.
Results: Regarding the PA At/Et ratio, there were statistically significant differences between infants born to mothers with managed diabetes and children delivered without RDS; however, there were no statistically significant changes with regard to the other PA Doppler parameters. The Receiver-operating characteristic (ROC) curve for predicting RDS in patients with controlled DM using PA At/Et ratio had excellent predictive value (AUC=0.740, p-value 0.012), and the mean PA At/Et ratio was significantly higher in infants born with RDS than infants born without RDS in women with controlled DM (0.34 vs 0.21, respectively). A cutoff criterion of PA At/Et ratio >0.25 exhibited an 88.9% specificity and a 75% sensitivity.
Conclusion: PA Further research should focus on individuals with difficult and uncontrolled diabetes mellitus and a bigger sample size in order to predict the foetal lung maturity in managed DM patients using the At/Et ratio.