Case Study: Fetal Breathing Movements as a Proxy for Fetal Lung Maturity Estimation

TL;DR

This study explores fetal breathing movements as a non-invasive proxy for fetal lung maturity, showing a potential inverse relationship with surfactant levels, which could lead to new assessment methods for high-risk pregnancies.

Contribution

It provides evidence that fetal breathing movements inversely correlate with surfactant levels, proposing FBM as a non-invasive tool for fetal lung maturity estimation.

Findings

FBM episodes decreased after corticosteroid treatment

Inverse coupling between FBM and surfactant levels observed

Potential for non-invasive FLM assessment suggested

Abstract

Premature births can lead to complications, with fetal lung immaturity being a primary concern. Currently, fetal lung maturity (FLM) requires an invasive surfactant extraction procedure between the 32nd and 39th weeks of pregnancy. Unfortunately, there is no non-invasive method for FLM assessment. This work hypothesized that fetal breathing movement (FBM) and surfactant levels are inversely coupled and that FBM can serve as a proxy for FLM estimation. To investigate the correlation between FBM and FLM, antenatal corticosteroid (ACS) was administered to increase fetal pulmonary surfactant levels in a high-risk 35th-week pregnant woman showing intrauterine growth restriction. Synchronous sonographic and phonographic measurements were continuously recorded for 25 minutes before and after the ASC treatments. Before the ACS injection, 268 continuous movements FBM episodes were recorded. The number of continuous FBM episodes significantly decreased to 3, 43, and 79 within 24, 48, and 72 hours, respectively, of the first injection of ACS, suggesting an inversely coupled connection between FBM and surfactant level s. Therefore, FBM may serve as a proxy for FLM estimation. Quantitative confirmation of these findings would suggest that FBM measurements could be used as a non-invasive and widely accessible FLM-assessment tool for high-risk pregnancies and routine examinations.