Perinatal outcome of fetal pulmonary pathology in relation to pulmonary volume measured with nuclear magnetic resonance

Abstract

Introduction: The prognosis in fetal lung disease is related to the size of the pulmonary malformation and secondary pulmonary hypoplasia. The mass effect on the underlying fetal lung results in a decrease in fetal lung volume and an increased likelihood of developing respiratory distress during the neonatal period. Objectives: Estimate the lung volume cut-off points related to neonatal morbidity and mortality in fetuses with congenital pulmonary malformation measured through magnetic resonance imaging. Methodology: Analytical retrospective cohort study from July 1, 2013, to June 30, 2017. Lung volumes were measured by magnetic resonance imaging in fetuses with congenital pulmonary malformation. The different measures are described and the association of lung volume with neonatal mortality is evaluated. Results: We analyzed 26 fetuses with congenital pulmonary malformation. The mortality described was 46.1% (12/26). The mean lung volume in the group with mortality was 19.7cm3 (95% CI 12.1-27.3), vs 58.6cm3 in the group without mortality (95% CI 39.0-78.1) (p=0.0010). Average lung volumes less than 34.9 cm3 were associated with higher mortality. Conclusion: The perinatal result of fetal lung disease is related to lung volume measured with Fetal Magnetic Resonance Imaging, finding that lung volumes less than 34.9cm3 were associated with higher mortality.