Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2021, Vol 37, Num, 2     (Pages: 154-160)

Evaluation of Pulmonary Hypoplasia in Various Congenital Anomalies with a Comparison of Two Conventional Methods of Assessment: Radial Alveolar Count (RAC) and Lung Weight: Body Weight Ratio (LBW)

Deepu Mathew CHERIAN 1, C. N. Sai SHALINI 2, Chitra ANDREWS 3, Uma MAHESWARI 4, Prathiba D 2

1 Department of Pathology, Indian Institute of Medical Science and Research, Warudi, MAHARASHTRA, INDIA
2 Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, TAMIL NADU, INDIA
3 Department of Obstetrics and Gynecology, Sri Ramachandra Institute of Higher Education and Research, TAMIL NADU, INDIA
4 Department of Neonatology and SCOPE, Sri Ramachandra Institute of Higher Education and Research, TAMIL NADU, INDIA

DOI: 10.5146/tjpath.2021.01521
Viewed: 412
 - 
Downloaded : 307

Objective: Pulmonary hypoplasia is common in the perinatal period and causes death in newborn infants. It is commonly associated with a number of malformation syndromes. Various parameters are used to estimate pulmonary hypoplasia at fetal autopsy including Lung Weight Body Weight ratio (LW:BW), Radial Alveolar Count (RAC) and DNA estimation.

Material and Method: This study was carried out as a retrospective analysis of 108 lung specimens of fetuses with congenital anomalies for a period of five years. All terminated fetuses with anomalies were received with 10% formalin. An inverted Y-shaped incision was made on the fetus to remove the lungs. Lung weight and body weight were measured and the ratio was calculated. Morphometric estimation of RAC was done microscopically by counting the number of alveoli using the Q capture software. RAC was calculated based on gestational age.

Results: Among the restrictive lung diseases, pulmonary hypoplasia by the LW:BW ratio was prevalent in 43% while the same by RAC was 19%. Similarly, pulmonary hypoplasia by the LW:BW ratio was prevalent in 35% while the same by RAC was 26% among cases with non restrictive lung diseases. Oligohydramnios showed the highest prevalence of pulmonary hypoplasia (23.7%), followed by renal anomalies (16.9%) and CNS anomalies (15.2%).

Conclusion: Pulmonary hypoplasia is a common occurrence in many congenital anomalies, premature rupture of membranes, and hydrops fetalis. Identifying the anomaly during the intrauterine period will help to anticipate and accordingly manage the baby in the postpartum period. Early diagnosis of correctable condition like oligohydramnios will also help in the early intervention and prevention of pulmonary hypoplasia.

Keywords : Congenital anomalies, Pulmonary hypoplasia, Lung weight, Body weight ratio, Radial alveolar count