Ultrasonic Evaluation Of Fetal Lung Regularity In Middle And Late Pregnancy And Its Correlation With Gestational Diabetes Mellitus

Part one Assessment of fetal lung development in using two-dimensional ultrasound examinationObjective Measure the left and right pulmonary longitudinal diameter,total lung area and volume,heart area,thoracic area,thoracic circumference and heart are/total lung area using two-dimensional ultrasound in the middle and late trimester of pregnancy,study the changes of these parameters with gestational age and evaluate fetal lung development by these parameters.Methods In 356 cases of normal singleton pregnancy,two-dimensional ultrasound scanning were conducted at 20-40 weeks.The lung area,heart area,thoracic area and thoracic circumference was traced in the four chamber view using trace method.Then the ratios of heart area to total lung area were calculated.The distance of left diaphragmatic dome to left lung apex and the right diaphragmatic dome to right lung apex were measured respectively on the left and right fetal lung parasagittal planes.Then calculation of left and right lung volume and total lung volume was carried out.Spearman correlation of gestational age and left and right pulmonary longitudinal diameter,total lung area and volume,heart area,thoracic area,thoracic circumference were calculated in bivariate correlation analysis.Plot the growth curve of left and right pulmonary longitudinal diameter,total lung area and volume,heart area,thoracic area,thoracic circumference of the fetus at 20-40 weeks of pregnancy,obtain the linear equation and calculate the regression linear equation.Results Reference range of fetal left and right pulmonary longitudinal diameter,total lung area and volume,heart area,thoracic area,thoracic circumference at 20-40 weeks of pregnancy were obtained.The rule of the increase of each parameter with the gestational Age: the value of each parameter increases with the increase of gestational age,present positive correlation with gestational weeks,the lung area and heart area grew faster in 20-29 weeks,thoracic area grew faster after 29 weeks,left and right pulmonary longitudinal diameter and total lung volume have a constant increace in the whole week of pregnancy.The relationship between the ratio of heart area to total pulmonary area: the ratio of heart area to total lung area from 20 to 40 weeks gestation was in constant range: 0.56-0.77.Conclusions Fetal left and right pulmonary longitudinal diameter,total lung area and volume,heart area,thoracic area,thoracic circumference increases with the increase of gestational age at 20-40 weeks of pregnancy.The ratio of heart area to total lung area from 20 to 40 weeks gestation is in constant range.These parameters can provide valuable reference for prenatal evaluation of fetal lung development.The application of two-dimensional ultrasound in the measure of fetal ling parameters is convenient,easy and repeatable,and the volume of fetal lung correlates well with gestational age,so it can be used as a routine method to evaluate fetal lung development.Part two The study of prenatal ultrasound on fetal lung development in gestational diabetes mellitusObjective To investigate the significance of the application of prenatal ultrasound technology to the fetal lung development evaluation in gestational diabetes mellitus.Methods The thirty-eight cases of patients with gestational diabetes mellitus were selected in the third people Hospital of Linyi between May in 2016 and May in 2017,for those who has poor blood sugar control into the Group A(8 cases),who has good blood sugar into the Group B(30 cases),and choose thirty pregnant women with good health as control group(group C).The application of two-dimensional ultrasound technique is to measure the correlation index of fetal lung in 24-25+6weeks ?28-29+6weeks and 34-35+6weeks respectively,including the left and right pulmonary longitudinal diameter,the total lung area and volume.Though comparing and analyzing the related parameters of the lungs from the three groups of fetus,to discuss the correlation between those parameters and gestational diabetes mellitus.Results In 24-25+6weeks ? 28-29+6weeks and 34-35+6weeks,the left and right longitudinal diameter,the total area and the total volume of lung in group A is(3.32±0.17 cm ? 3.61±0.20 cm ? 11.68±1.28cm2 ? 33.27±2.44cm3),(4.03±0.15 cm ?4.18±0.17 cm ? 16.35±0.60cm2 ? 47.61±2.34cm3),(4.45±0.12 cm ? 4.56±0.14 cm ?19.50±1.26cm2?69.60±1.65cm3),the parameters of the fetal lung in group A are greater than group C,there is no difference between group B and group C.Conclusions The application of prenatal ultrasound technique to evaluate fetal lung examination is of higher clinical value for the fetal lung development in pregnancy.