New anatomical landmarks to study the relationship between fetal lung area and thoracic circumference by three-dimensional ultrasonography

Ingrid Schwach Werneck Britto, Giselle Darahem Tedesco, Sandra Rejane Silva Herbst, Luiz Cláudio Silva Bussamra, Fernando Moreira De Andrade, Edward Araujo Júnior, Luciano Marcondes Mac Hado Nardozza, Rodrigo Ruano, Antonio Fernandes Moron, Tsutomu Aoki

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objective: To evaluate the relation between total lung area (TLA) and thoracic circumference (TC) ratio by three-dimensional (3D) ultrasonography applying new anatomical landmarks as the fetal aorta and inferior angle of the scapula. Methods: A longitudinal prospective study was conducted with 56 uncomplicated pregnancies between 24 and 32 weeks of gestation. Polynomial regressions were used to evaluate the correlation between TC and gestational age (GA) as well as TC and estimated fetal weight (EFW). A simple linear regression was used to evaluate the correlation between TLA and Total thoracic area (TTA) and GA. The intraclass correlation coefficient (ICC) was used to assess the intra and interobserver variability. Results: 127 examinations were performed. TC values ranged from 150 to 174mm (mean 166mm) at 24 weeks and 215248mm (mean 231mm) at 32 weeks. The TLA/TC ratio ranged from a mean of 0.64 at 24 weeks (range 0.560.70) to 0.90 at 32 weeks gestation (range 0.791.01). The intraobserver variability using the ICC was of 0.919 for TC; 0.916 for TTA; 0.860 for right lung area (RLA) and 0.910 for left lung area (LLA). Interobserver reproducibility was with an ICC of 0.970 for TC; 0.984 for RLA and 0.910 for LLA. Conclusions: Measurement of fetal TC and the relationship between TLA and TC by 3D-ultrasonography applying new anatomical landmarks shows good reproducibility and allows a new assessment of thoracic and lung growth.

Original languageEnglish (US)
Pages (from-to)1927-1932
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Issue number10
StatePublished - Oct 2012


  • Fetal lung area
  • Fetal thoracic circumference
  • Multiplanar mode
  • Reference intervals
  • Three-dimensional ultrasonography

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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