الفهرس 
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Abstract
This work aimed at comparing two noninvasive ultrasonographic techniques namely, quantitative ultrasound texture analysis of the fetal lung (QuantusFLM) and fetal pulmonary artery Doppler for the evaluation of fetal lung maturity, comparing their value in the prediction of the occurrence of neonatal respiratory distress syndrome.
A prospective cohort study was developed, in which 65 pregnant women were examined from among cases delivering in The Department of Obstetrics and Gynecology in Minia University Hospital in the period from the May 2018 till the end of the year. All of the patients underwent ultrasound examination to obtain fetal pulmonary artery acceleration time to ejection time ratio (AT/ET), Resistance index (RI) and pulsatility index (PI) as well as a greyscale axial ultrasound image of the fetal lungs, which were analyzed using Quantus-FLM software online application. 25 patients were excluded from the study due to giving birth more than 48 hours after the ultrasound examination, corticosteroid administration in between the examination and delivery, congenitally malformed fetuses, neonatal sepsis or respiratory distress due to causes other than neonatal RDS. After delivery the neonates were grouped according to diagnosis of RDS as RDS +ve and RDS -ve.
Neonatal RDS was diagnosed by neonatologist, blinded to fetal MPA Doppler and Quantus FLM results by the presence of at least 2 of 3 of these criteria: any evidence of respiratory failure (tachypnea, retraction and, or nasal fairing) shortly after birth and increased oxygen requirement, radiographic evidence of hyaline membrane disease such as reticulo-nodular pattern and ground glass appearance or the response to exogenous pulmonary surfactant.
Of the 40 eligible fetuses, 9 (22%) developed neonatal RDS. Acceleration time to ejection time ratio (AT/ET) and Quantus FLM results were significantly correlated with the development of neonatal RDS. At/Et was significantly lower in fetuses that developed RDS. A cutoff value of 0.3 for At/Et predicted the development of RDS (sensitivity: 77.78 %; specificity: 83.87 %) while Quantus FLM predicted neonatal RDS with 88.89 % sensitivity and 90.32 %. specificity.