Predicción de la madurez fetal mediante la caracterización ultrasónica del pulmón

Article information

Resumen

Objetivo

Evaluar la utilidad del examen computarizado de la textura ecográfica del pulmón fetal en la determinación de la madurez fetal

Material y métodos

Mediante ecografía realizada en 230 fetos de edades gestacionales comprendidas entre las semanas 20 y 42, se obtuvo un histograma de frecuencias de pulmón e hígado fetales, así como la relación entre ambos órganos, analizándose el nivel medio de grises, la desviación estándar y la anchura del histograma. En 20 casos, los datos ecográficos se compararon con los bioquímicos obtenidos en líquido amniótico

Resultados

El hígado no presenta cambios en el patrón de reflexión en las diferentes edades gestacionales, mientras que a partir de la semana 33-34 la ecorrefringencia pulmonar se incrementa significativamente. Estas modificaciones también se manifiestan cuando analizamos la anchura del histograma (AHP/H), e igualmente se hacen patentes al relacionarse con datos biométricos fetales o estadios de desarrollo pulmonar. Se obtienen correlaciones significativas al comparar el nivel medio de grises pulmón/hígado (NMGP/H) y AHP/H con varios parámetros bioquímicos en el líquido amniótico, particularmente con el índice L/S y DO650

Conclusiones

El pulmón fetal está maduro cuando la ecogenicidad pulmonar es mayor que la hepática, siendo el NMGP/H superior a la unidad (1,04) y la AHP/H es de 2,2

Palabras clave:

Madurez pulmonar fetal

Caracterización tisular ultrasónica

Abstract

Aim

To evaluate the usefulness of computerized ultrasound texture analysis of fetal lung in the determination of fetal maturity

Material And Methods

Histograms of fetal lung and liver frequency were obtained by ultrasonography in 230 fetuses aged between 20 and 42 weeks. The relationship between both organs was analyzed by mean grey-levels, standard deviation and histogram width. In 20 fetuses, sonographic data were compared with biochemical data obtained from amniotic fluid

Results

The liver showed no changes in the reflection pattern in the different gestational ages while from weeks 33-34 pulmonary sonographic refringency significantly increased. These modifications were also seen when we analyzed histogram width and on comparison with fetal biometric data or stages of lung development. Significant correlations were obtained when mean grey-levels of the lung/liver and histogram width were compared with several biochemical parameters in amniotic fluid, particularly with the L/S index and OD 650

Conclusions

The fetal lung is mature when pulmonary echogenicity is greater than that of the liver and when the mean grey-level of the lung/liver is higher than unit (1.04) and histogram width is 2.2

Keywords:

Fetal lung maturity

Tisular ultrasound characterization

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