Diagnostic applications of neonatologist-performed lung ultrasound in the delivery room in late preterm and term neonates: A systematic review of literature.

Lung ultrasound (LUS) is increasingly used in the delivery room to assess respiratory transition and guide early respiratory management. The objective of this systematic review was to evaluate current evidence on the diagnostic applications of neonatologist-performed LUS during neonatal resuscitation and immediate postnatal stabilization in late preterm and term neonates. Twelve studies were included in this qualitative systematic review, addressing physiological LUS patterns after birth, the use of LUS scoring systems to predict the requirement of respiratory support, and applications of LUS during neonatal resuscitation and immediate postnatal stabilization. Normal postnatal adaptation was characterized by rapid progression from fluid-rich to aerated lung patterns, whereas persistent high-risk LUS patterns were associated with respiratory morbidity. Several LUS scoring systems demonstrated good discriminative ability for predicting the need for respiratory support shortly after birth. In addition, characteristic ultrasound patterns supported early identification of late preterm and term neonates at risk for surfactant requirement and mechanical ventilation. Despite substantial heterogeneity in study design, timing of imaging, and analytic methods, the evidence supports the feasibility and clinical value of LUS in the delivery room. Neonatologist-performed LUS represents a promising bedside tool that may complement clinical assessment during early postnatal transition in late preterm and term neonates.