The First 100% Non-Invasive Fetal Lung Maturity Test in the Market

What is quantusFLM?

quantusFLM is an 100% non-invasive Fetal Lung Maturity test based on the analysis of an ultrasound image of the fetal lungs.

quantusFLM works as a web application that allows you to upload the ultrasound images for automatic analysis and review the reliable results within minutes.

quantusFLM offers you an unprecedented solution to predict the risk of Neonatal Respiratory Morbidity in a non-invasive, reliable and fast manner.

Comparision of quantusFLM and other commerical FLM tests

  Sensitivity Specificity PPV NPV
L/S Ratio A 74.6% 82.5% 34.1% 94.4%
PG A 82.7% 54.4% 18.0% 96.3%
Lamellar Body A 84.2% 74.4% 27.9% 97.6%
quantusFLM B 71.0% 94.7% 67.9% 95.4%
L/S: Lecithin / Sphingomyelin
PG: Phosphatidol Glycerol
Average reported values (references 1-6) in clinical studies
B Reported results in clinical study (reference 22)

Why quantusFLM is different?

quantusFLM provides a NON-INVASIVE and EFFICIENT solution to determine the Fetal Lung Maturity.

Current FLM tests based on amniotic fluid analysis

Extract amniotic fluid
Lab analysis
Get the results


Acquire ultrasound images
Send the images to quantusFLM web app for analysis
Get the results

The web-based solution enables TIMESLESS and BORDERLESS user experience.

Unrestricted and 24/7 access: As long as there is Internet, you can use quantusFLM and review the results ANYTIME, ANYWHERE.

No installation required: quantusFLM is designed to give new users an easy start because neither downloading nor installation of any software is required.

Great compatibility: quantusFLM is compatible with major web browsers as well as most commonly-used Obstetrics and Gynecology Ultrasound Machines.

Why is quantusFLM useful?

Determining Fetal Lung Maturity is a Historical Need

Information about Fetal Lung Maturity* may be of help to assess the decision of deliverying when the balance between the risk of Neonatal Respiratory Morbidity** and the fetal or maternal risk to prolong pregnancy is not clear.

Maternal or fetal conditions such as moderate preeclampsia, diabetis, cholestasis or growth restriction may need to plan delivery before the spontaneous labor occurs. Although Neonatal Respiratory Morbidity is much more frequent in early preterm babies, it also occurs in late preterm babies (>34 weeks) and even in early term newborns.

For that reason, reference associations like ACOG recommend that obstetricians confirm fetal pulmonary maturity prior to elective delivery with less than 39 weeks gestation. That information, directly related with the risk of Neonatal Respiratory Morbidity, is advisable in order to plan place and time of delivery together with the neonatologists.

However, the main problem is that all the present FLM tests require an invasive amniocentesis procedure that not only causes discomfort to the patients but also poses potential complications. Therefore, despite the majority of the clinicians consider conducting FLM test important, the intrinsic complications of the current methods greatly compromise its massive use.

* The term "Fetal Lung Maturity" is universally used by the scientific and medical community to define the capacity of fetal lungs to achieve normal respiratory function if the fetus is born.

** Defined as either Respiratory Distress Syndrome or Transient Tachypnea of the newborn that requires his admission to a special unit and the use of medical respiratory support.

When to use quantusFLM?

From a Evidence-Based Medicine to a Personalized Medicine

quantusFLM can be particularly useful where elective delivery could be an acceptable option but the risk of neonatal respiratory morbidity should be known. In many clinical situations the decision of whether to deliver or wait is in a "grey zone", particularly in late preterm to early-term (34+0 to 38+6 weeks) pregnancies. Typical examples can be:

  • Difficult-to-control hypertension or diabetes
  • Moderate preeclampsia
  • Maternal fluid retention with edema
  • Very symptomatic cholestasis
  • Previous history of unexplained fetal death or abruption
  • Any situation where an elective cesarean section <39+0 weeks is considered

In these and other circumstances delivery may be a reasonable, but not an absolute, option to avoid danger to mother or fetus. Knowing the risk of neonatal respiratory morbidity in a non-invasive manner, can be a critical information in the decision-making process, either to confirm or otherwise delay delivery.

For instance, in a 36+0 week pregnancy, the baseline risk of morbidity and NICU admission for respiratory support is 6.1%. However, a risk adjusted by quantusFLM below the baseline risk might reduce the chances of morbidity to 5.2%, while if the risk adjusted by quantusFLM is above the baseline risk, the probability of respiratory morbidity migth be 33.7%. Thus, knowing FLM (without the need of any invasive technique) may have a clear impact in the clinical management of this case.

Why does quantusFLM work?

Changes occurring at the histological level of a tissue, including the proportion of collagen, fat or water, among others, affect ultrasound backscattering signals. This constitutes the basis for ultrasound image reconstruction. Computerized quantitative ultrasound analysis detects extremely subtle changes, unpercievable by the human eye, in order to accurately infer relevant information of tissue microstructure.

Fetal Lung Maturity constitutes an obvious candidate for the use of quantitative ultrasound solutions as fetal lung maturity results from the combination of the evolving changes in lung airways and alveoli during gestation, and the concentration of surfactant. Over the last 30 years, research has focused on the extraction of quantitative information about tissue characteristics from ultrasound images.

quantusFLM brings the opportunity to avoid the need of using an invasive technique to predict neonatal respiratory morbidity in the clinical practice. Transmural Biotech's quantusFLM software uses a combination of cutting-edge image analysis technologies that make individualized predictiveness of the risk of Neonatal Respiratory Morbidity.

quantusFLM reaches unprecedented levels of accuracy and reproducibility for a completely non-invasive ultrasound-based test.


  1. A comparison of the accuracy of the TDx-FLM assay, Lecithin-Sphingomyelin Ration, and Phosphatidyglycelrol in the prediction of Neonatal Respiratory Distress Syndrome. E. Hagen, JC. Link and F. Arias. Obstet Gynecol (1993) 82, 1004-8.
  2. A Direct Comparison Between Lamellar Body Counts and Fluorescent Polarization Methods for Predicting Respiratory Distress Syndrome. S. Haymond, VI. Luzzi, CA. Parvin and AM. Gronowski. Am J Clin Pathol (2006) 126,894-899.
  3. Gestational age-specific predicted risk of neonatal respiratory distress syndrome using lamellar body count and surfactant-to-albumin ratio in amniotic fluid. R. Karcher, E. Sykes, D. Batton,Z. Uddin, G. Ross, E. Hockman and GH. Shade Jr. AJOG (2005) 193, 1680–4.
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  22. Prediction of Neonatal Respiratory Morbidity by Quantitative Ultrasound Lung Texture Analysis: A Multicenter Study, American Journal of Obstetrics and Gynecology (2017), doi: 10.1016/j.ajog.2017.03.016.


A Revolution in Fetal Lung Maturity Tests

Non Invasive