Fetal lung volume and pulmonary artery changes in congenital heart disease with decreased pulmonary blood flow: Quantitative ultrasound analysis

Echocardiography. 2018 Jan;35(1):85-89. doi: 10.1111/echo.13724. Epub 2017 Oct 10.

Abstract

Background: It has been reported that congenital heart disease with decreased pulmonary blood flow (CHD-DPBF) may affect postnatal lung morphogenesis and function. However, there has been a lack of information regarding the impact of CHD-DPBF on prenatal fetal lung development.

Methods: Fifty-four fetuses with CHD-DPBF were compared with 110 controls. Fetal lung volume (FLV) was estimated using three-dimensional ultrasonography (3D-US). Estimated fetal weight (EFW) and McGoon index (MGI) were estimated using two-dimensional ultrasonography (2D-US).

Results: FLV/EFW and MGI values measured using sonography for the CHD-DPBF group were significantly reduced compared to those of the control group (P < .05). Pearson correlation analysis indicated that the summed diameter of the right pulmonary artery and left pulmonary artery (RPA + LPA) measured by 2D-US correlated well with FLV measured by 3D-US.

Conclusions: In our study, FLV/EFW and MGI values for fetuses with CHD-DPBF tended to be decreased and FLV was associated with RPA + LPA. We concluded that CHD-DPBF might delay fetal lung development. The summed diameter of the RPA + LPA measurement could be used as an alternative to FLV for assessing fetal lung development.

Keywords: congenital heart disease; fetal echocardiography; pulmonary artery; three-dimensional echocardiography.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Evaluation Studies as Topic
  • Female
  • Heart Defects, Congenital / diagnostic imaging
  • Heart Defects, Congenital / physiopathology*
  • Humans
  • Lung / diagnostic imaging*
  • Lung / embryology*
  • Lung / growth & development
  • Middle Aged
  • Pregnancy
  • Prospective Studies
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Artery / embryology*
  • Pulmonary Artery / physiopathology*
  • Ultrasonography, Prenatal / methods*
  • Young Adult