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Assessment of the fetal lungs in utero

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Original languageEnglish
Article number100693
JournalAmerican journal of obstetrics & gynecology MFM
Volume4
Issue number5
Early online date17 Jul 2022
DOIs
Accepted/In press12 Jul 2022
E-pub ahead of print17 Jul 2022
PublishedSep 2022

Bibliographical note

Funding Information: J.H. is supported by core funding from the Wellcome/Engineering and Physical Sciences Research Council (EPSRC) Centre for Medical Engineering (WT203148/Z/16/Z), by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Human Placenta Project grant 1U01HD087202-01 (Placenta Imaging Project), by the Wellcome Trust, For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Sir Henry Wellcome Fellowship, (201374/Z/16/Z), by the UK Research and Innovation, Future Leaders Fellowship (MR/T018119/1), and by the NIHR Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust and King's College London. Funding Information: L. S. is a National Institute for Health and Care Research (NIHR) Advanced Fellow and is funded by Health Education England and NIHR for this research project. The views expressed in this publication are those of the authors and not necessarily those of the NIHR, National Health Service (NHS), or the UK Department of Health and Social Care. Funding Information: L. S. is a National Institute for Health and Care Research (NIHR) Advanced Fellow and is funded by Health Education England and NIHR for this research project. The views expressed in this publication are those of the authors and not necessarily those of the NIHR, National Health Service (NHS), or the UK Department of Health and Social Care. J.H. is supported by core funding from the Wellcome/Engineering and Physical Sciences Research Council (EPSRC) Centre for Medical Engineering (WT203148/Z/16/Z), by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Human Placenta Project grant 1U01HD087202-01 (Placenta Imaging Project), by the Wellcome Trust, For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Sir Henry Wellcome Fellowship, (201374/Z/16/Z), by the UK Research and Innovation, Future Leaders Fellowship (MR/T018119/1), and by the NIHR Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust and King's College London. Publisher Copyright: © 2022 The Authors

King's Authors

Abstract

Antenatal diagnosis of abnormal pulmonary development has improved significantly over recent years because of progress in imaging techniques. Two-dimensional ultrasound is the mainstay of investigation of pulmonary pathology during pregnancy, providing good prognostication in conditions such as congenital diaphragmatic hernia; however, it is less validated in other high-risk groups such as those with congenital pulmonary airway malformation or preterm premature rupture of membranes. Three-dimensional assessment of lung volume and size is now possible using ultrasound or magnetic resonance imaging; however, the use of these techniques is still limited because of unpredictable fetal motion, and such tools have also been inadequately validated in high-risk populations other than those with congenital diaphragmatic hernia. The advent of advanced, functional magnetic resonance imaging techniques such as diffusion and T2* imaging, and the development of postprocessing pipelines that facilitate motion correction, have enabled not only more accurate evaluation of pulmonary size, but also assessment of tissue microstructure and perfusion. In the future, fetal magnetic resonance imaging may have an increasing role in the prognostication of pulmonary abnormalities and in monitoring current and future antenatal therapies to enhance lung development. This review aims to examine the current imaging methods available for assessment of antenatal lung development and to outline possible future directions.

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