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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

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Predicting neonatal RDS with fetal pulmonary artery doppler: a diagnostic performance and ROC curve analysis.

Ishan Kumar¹, Karan Kukreja², Ashok Kumar²

¹Banaras Hindu University, Varanasi, India. ishan.imsrd@bhu.ac.in.

The Ultrasound Journal

|November 5, 2025

Summary

Fetal main pulmonary artery (MPA) Doppler parameters can predict respiratory distress syndrome (RDS) in preterm neonates. Specific Doppler indices effectively identify fetuses at risk for RDS and its severity.

Keywords:

Doppler ultrasonography Newborn Prenatal diagnosis Pulmonary artery Respiratory distress syndrome

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Area of Science:

Perinatology
Fetal Medicine
Neonatology

Background:

Respiratory distress syndrome (RDS) is a significant concern in preterm neonates.
Accurate prediction of RDS is crucial for timely intervention and improved outcomes.
Non-invasive methods for predicting RDS are highly desirable in clinical practice.

Purpose of the Study:

To evaluate fetal main pulmonary artery (MPA) Doppler parameters as non-invasive predictors of RDS.
To assess the relationship between MPA Doppler indices and gestational age.
To correlate MPA Doppler findings with postnatal respiratory outcomes in neonates.

Main Methods:

Prospective observational diagnostic accuracy study.
Pulsed-wave Doppler of the fetal MPA was performed.
Doppler indices including pulsatility index (PI), resistance index (RI), and acceleration time/ejection time ratio (At/Et) were recorded and analyzed.

Main Results:

In fetuses developing RDS, At/Et was persistently low, while PI and RI were elevated compared to normally developing fetuses.
Specific cutoff values for At/Et (<0.24), RI (>0.8), and PI (>2.16) effectively predicted RDS.
These Doppler parameters were independent predictors of RDS and its severity in preterm neonates.

Conclusions:

Fetal MPA Doppler parameters are reliable non-invasive predictors of RDS.
These parameters can also predict the severity of RDS in preterm neonates.
MPA Doppler assessment offers a valuable tool for risk stratification in high-risk pregnancies.