Re: Fetal lung maturity
From: Terry J DuBose (tjdubose@juno.com)
Thu Jul 12 09:00:24 2001
Dr. Fougner, you are correct. I focused on the question of lung maturity
and sonography rather than the management of this particular case.
Thanks for keeping our feet on the ground.
--
Terry J DuBose
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On Wed, 11 Jul 2001 20:12:44 -0500 evsono@pipeline.com (art fougner, md)
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writes:
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> what would be the pressing need to determine lung maturity in a 26 wk
> pregnancy? aside from administering steroids, would favor managing
> the
> situation clinically. tough call here to be sure but would not
> deliver
> solely on the basis of afi at 26 wks.
>
> just my opinion - i could be wrong.
>
> art
>
> At Wed, 11 Jul 2001, DuboseTerryJ@uams.edu wrote:
> >
> >Dear Dr. D'Angelo, your question is an excellent one... one that
> really
> >needs a solution. If someone could come up with a foolproof method
> of
> >determining fetal lung maturity using ultrasound they would win the
> whole
> >set of dishes!
> >
> >A long time ago, in the Dark Ages of sonography, before 1985 there
> were some
> >papers that proposed that lung maturity might be assessed by
> comparing it to
> >the liver. The theory was that when the alveoli started filling
> out the
> >lung would go from being less echogenic than the liver to being
> more
> >echogenic. Unfortunately, subsequent studies found it to be a very
> >unreliable technique.
> >
> >At the 1998, Edinburgh, Scotland, 8th World Congress on Ultrasound
> in
> >Obstetrics & Gynecology, there was a Fetal Lung: Round Table
> Discussion. I
> >have a brief review of this panel discussion at:
> >http://www.obgyn.net/us/us.asp?page=/us/news_articles/ISUOG/Fetal-Lung
> . In
> >this review I give a brief description of each research project,
> world wide,
> >that is trying to solve the lung maturity quandary.
> (Unfortunately, the
> >links to the photographs of some of the panel members and some of
> their
> >slides are broken... hopefully repaired soon. )
> >
> >There were reports of research on fetal lung maturity and Doppler
> of the
> >pulmonary arteries and veins in an attempt to solve this problem.
> No
> >definite results yet, but it is a promising direction to go. My
> gestalt
> >tells me that there should be some change in the pulmonary
> perfusion when
> >the lungs mature...probably a drop in the RI, but we need someone
> to figure
> >out how to do that. Others were trying to use Doppler to measure or
> estimate
> >the rate of fluid movement in fetal breathing motions... also not
> successful
> >yet.
> >
> >Sorry I can't give you a better answer.
> >
> >Peace, Terry J. DuBose, M.S., RDMS, APS
> >Assistant Professor & Director, Diagnostic Medical Sonography
> Program
> >CHRP, University of Arkansas for Medical Sciences
> >Little Rock, Arkansas, USA
> >501-686-6510
> >http://www.io.com/~dubose/
> >http://www.uams.edu/CHRP/dmshome.htm
> >http://www.obgyn.net/us/panel/panel.htm
> >
> >-----Original Message-----
> >From: Pablo D'Angelo [mailto:pjd@post.com]
> >Sent: Wednesday, July 11, 2001 3:26 PM
> >To: Multiple recipients of list ULTRASOUND
> >Subject: Fetal lung madurity
> >
> >Hello
> >
> >Someone knows if there is any RELIABLE way to determine fetal lung
> madurity
> >with ultrasound?
> >
> >We had a pregnant woman 26 weeks of gestation with premature
> rupture of
> >membranes from 4 weeks ago, with an AFI that never exceeded 10 mm.
> >We need to know lung madurity.
> >
> >Any idea?
> >
> >Thanks
> >
> >--
> >Pablo D'Angelo, MD
> >from Argentina
> >
>
> --
> art fougner, md
>
> A series of 1000 cases begins with but a single anecdote.
