EP08.06: Prediction of severity of lung hypoplasia in the fetuses with prolonged premature rupture of membrane
Bibliographic record
Abstract
Prolonged premature rupture of membrane (pPROM) early in gestation can be associated with high neonatal mortality and morbidity due to severe lung hypoplasia (LH). LH severity indices have been developed for fetal diaphragmatic hernia and other causes of LH, however, to date, there is little data regarding predictors of LH severity in pPROM. Smaller branch pulmonary arteries (PA) and abnormal PA Doppler profiles including shorter acceleration to ejection time (AT/ET) and higher pulsatility index (PI) with little or no response to maternal hyperoxia have been demonstrated in fetuses with severe LH. The current study aim was to determine whether these features correlate with worse LH and clinical outcomes in pPROM. Pregnancies complicated by pPROM (n = 30, age at study 27.9 ± 4.1 weeks) and healthy pregnancies (n = 56) were prospectively recruited for fetal echocardiography to assess LH indices. Branch PA diameters were measured and a z-score was generated based on our normative data. After baseline AT/ET and PI were assessed, 8L/min O2 was administered to the mother by non-reservoir mask. Five fetuses with pPROM demised in the neonatal period, all within 3 days and all from severe respiratory insufficiency. Duration of pPROM prior to delivery (9.29 ± 5.65 vs 9.86 ± 1.50 weeks, respectively), and mean gestational age at echo and at birth did not differ between survivors and nonsurvivors; whereas amniotic fluid index was significantly lower in non-survivors (0.64 ± 0.90 cm vs 4.17 ± 4.38 cm for survivors (p = 0.006). No difference was observed in right or left PA z-score or PI; however, right and left PA AT/ET was significantly shorter in nonsurvivors (0.13 ± 0.02 and 0.13 ± 0.02) compared to survivors (0.17 ± 0.02 and 0.16 ± 0.02)(RPA p = 0.004, LPA p = 0.04). Responsivity to maternal hyperoxia for both AT/ET and PI did not differ between groups. Fetal branch PA AT/ET may be useful in predicting LH severity and neonatal outcomes in pPROM.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".