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Prior to birth, the lungs are filled with amniotic fluid, mucus, and surfactant. As the fetus is squeezed through the birth canal, the fetal thoracic cavity is compressed, expelling much of this fluid. Some fluid remains, however, but is rapidly absorbed by the body shortly after birth.
Corticosteroids encourage the development of the lungs in a premature fetus before birth, [16] and are administered when the premature fetus is expected to be delivered within 24 to 48 hours. The period of optimal benefit begins 24 hours after administration and lasts 7 days.
Medical diagnosis of pulmonary hypoplasia in utero may use imaging, usually ultrasound or MRI. [12] [13] The extent of hypoplasia is a very important prognostic factor. [14]One study of 147 fetuses (49 normal, 98 with abnormalities) found that a simple measurement, the ratio of chest length to trunk length, was a useful predictor of postnatal respiratory distress. [15]
The fetus, which develops within a fluid-filled amniotic sac, relies on the placenta for respiratory gas exchange rather than the lungs. While not involved in fetal oxygenation, fetal breathing movements (FBM) nevertheless have an important role in lung growth and in development of respiratory muscles and neural regulation. FBM are regulated ...
In the fetal stage, the lungs fill with fluid and collapse because the fetus is within the amniotic sac and the placenta is providing the oxygen it needs to grow. With the lung collapsed, pulmonary vascular resistance remains high during the fetal stage to prevent blood flow into the lungs. [ 2 ]
"It's a really big driver of fetal lung development," she said. With a ruptured sac, "one of the major concerns, even if the baby survives, it won't have development of the lungs," she said.
In most cases the outcome of a fetus with CPAM is very good. In rare cases, the cystic mass grows so large as to limit the growth of the surrounding lung and cause pressure against the heart. In these situations, the CPAM can be life-threatening for the fetus. CPAM can be separated into five types, based on clinical and pathologic features. [2]
The lecithin–sphingomyelin ratio is a marker of fetal lung maturity. The outward flow of pulmonary secretions from the fetal lungs into the amniotic fluid maintains the level of lecithin and sphingomyelin equally until 32–33 weeks gestation, when the lecithin concentration begins to increase significantly while sphingomyelin remains nearly the same.