ANTENATAL DIAGNOSIS OF LUNG HYPOPLASIA:

Evaluating the fetal lung is a component of the ultrasonic assessment of newborn viability. We have combined subjective ultrasonic visualization of the lung with quantitative parameters including the ratio of cross sectional areas of the heart and thorax, average rib spacing (midaxillary line), relative lung reflectivity, and the occurrence and pattern of diaphragmatic movement. We have been able to recognize pulmonary hypoplasia antenatally in 21 cases, 18 through 35 weeks gestational age (3-renal agenesis, 3-renal dysgenesis, prune belly S., 3 nonimmune and 1 immune hydrops, 2-prolonged ROM, triploidy, trisomy 13, chromototrophic dwarves). We have also seen lesser degrees of hypoplasia with spondylocostal dysplasia, massive pulmonary replacement with adenomatoid malformation, 2 sequestrations, and one case of increased lung volume with decreased reflectivity later found to have laryngeal atresia.