Fetal Pulmonary Artery Doppler and QuantusFLM for the Assessment of Fetal Lung Maturity: A Systematic Review
Doppler de la arteria pulmonar fetal y QuantusFLM en la evaluación de la madurez pulmonar: Revisión sistemática
DOI:
https://doi.org/10.22258/hgh.v10i3.438Abstract
Objective: To evaluate the available evidence on the diagnostic performance of the fetal pulmonary artery Doppler index, particularly the acceleration-to-ejection time (AT/ET) ratio, compared to QuantusFLM®, for estimating fetal lung maturity and predicting neonatal respiratory morbidity. Methodology: A systematic review of observational studies published between 2019 and 2025 was conducted using the international electronic databases MEDLINE/PubMed and Scopus. Studies evaluating non-invasive ultrasound-based methods for assessing fetal lung maturity and reporting neonatal respiratory outcomes were included. Study selection was performed using the Rayyan platform, and risk of bias was assessed using the National Heart, Lung, and Blood Institute (NHLBI) Study Quality Assessment Tools. Due to the clinical and methodological heterogeneity of the included studies, a meta-analysis was not performed. Instead, findings were integrated through a qualitative and narrative synthesis comparing the characteristics of the diagnostic tests, the parameters assessed, and their performance in predicting fetal lung maturity and neonatal respiratory morbidity. Results: Fourteen observational studies with sample sizes ranging from 40 to 790 pregnancies were included. Fetal pulmonary artery Doppler indices showed a consistent association with the development of neonatal respiratory distress syndrome, with the TA/TE ratio being particularly noteworthy, exhibiting sensitivities between 71.4% and 94.8% and specificities between 79.7% and 96.2%. QuantusFLM® demonstrated high diagnostic accuracy, especially due to its high negative predictive value, exceeding 89% in most studies. Emerging methods, such as fetal pulmonary microvasculature assessment using MV-Flow Doppler, showed promising results. Most studies presented a moderate risk of bias. Conclusion: Non-invasive ultrasound methods, particularly QuantusFLM® and fetal pulmonary artery Doppler indices, show clinical utility for estimating fetal lung maturity and predicting neonatal respiratory morbidity, with the potential to complement traditional criteria based on gestational age. Keywords: Fetal Organ Maturity; Pulmonary Artery; Ultrasonography, Doppler (Source: MeSH, NLM).Downloads
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