Three-Dimensional Ultrasound Evaluation of Lung Volume in Fetuses with Abdominal Wall Defect

Abstract

<b><i>Introduction:</i></b> Abdominal wall defects (AWDs) interfere with postnatal respiratory parameters. We aimed to evaluate lung volume (LV) in fetuses with AWD using three-dimensional (3D) ultrasound (US) and to correlate AWD with the type (omphalocele and gastroschisis) and size of the defect and neonatal morbidity and mortality. <b><i>Methods:</i></b> This prospective observational study included 72 pregnant women with fetuses with AWD and a gestational age &lt;25 weeks. The data on abdominal volume, 3D US LV, and herniated volume were acquired every 4 weeks up to 33 weeks. LV was compared with normal reference curves and correlated with abdominal and herniated volumes. <b><i>Results:</i></b> Omphalocele (<i>p</i> &lt; 0.001) and gastroschisis (<i>p</i> &lt; 0.001) fetuses had smaller LV than normal fetuses. LV was positively correlated with abdominal volume (omphalocele, <i>r</i> = 0.86; gastroschisis, <i>r</i> = 0.88), whereas LV was negatively correlated with omphalocele-herniated volume/abdominal volume (<i>p</i> &lt; 0.001, <i>r</i> = −0.51). LV was smaller in omphalocele fetuses that died (<i>p</i> = 0.002), were intubated (<i>p</i> = 0.02), or had secondary closure (<i>p</i> &lt; 0.001). In gastroschisis, a smaller LV was observed in fetuses discharged using oxygen (<i>p</i> = 0.002). <b><i>Conclusion:</i></b> Fetuses with AWD had smaller 3D LV than normal fetuses. Fetal abdominal volume was inversely correlated with LV. In omphalocele fetuses, a smaller LV was associated with neonatal mortality and morbidity.