Fetal endoscopic tracheal occlusion and pulmonary hypertension in moderate congenital diaphragmatic hernia.

Autor:	Donepudi R; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA., Belfort MA; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA., Shamshirsaz AA; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA., Lee TC; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA., Keswani SG; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA., King A; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA., Ayres NA; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Department of Pediatrics - Cardiology Section, Baylor College of Medicine, Houston, TX, USA., Fernandes CJ; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Newborn Section, Baylor College of Medicine, Houston, TX, USA., Sanz-Cortes M; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA., Nassr AA; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA., Espinoza AF; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA., Style CC; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA., Espinoza J; Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA.; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
Jazyk:	angličtina
Zdroj:	The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2022 Dec; Vol. 35 (25), pp. 6967-6972. Date of Electronic Publication: 2021 Jun 06.
DOI:	10.1080/14767058.2021.1932806
Abstrakt:	Objective: To study the role of fetal endoscopic tracheal occlusion (FETO) on resolution of pulmonary hypertension (PH) in fetuses with isolated moderate left-sided diaphragmatic hernia (CDH). Methods: This retrospective study included fetuses with CDH evaluated between February 2004 and July 2017. Using the tracheal occlusion to accelerate lung growth (TOTAL) trial definition, we classified fetuses into moderate left CDH if O/E-LHR (observed/expected-lung head ratio) was 25-34.9% regardless of liver position or O/E-LHR of 35-44.9% if liver was in the chest. Postnatal echocardiograms were used to diagnose PH. Logistic regression analyses were performed to determine the relationship of FETO with study outcomes. Results: Of 184 cases with no other major anomalies, 30 (16%) met criteria. There were nine FETO and 21 non-FETO cases. By hospital discharge, a higher proportion of infants in the FETO group had resolution of PH (87.5 (7/8) vs. 40% (8/20); p =.013). FETO was associated with adjusted odds ratio of 17.3 (95% CI: 1.75-171; p =.015) to resolve PH by hospital discharge. No significant differences were noted in need for ECMO or survival to discharge between groups. Conclusions: Infants with moderate left-sided CDH according to O/E-LHR, FETO is associated with resolution of PH by the time of hospital discharge.
Databáze:	MEDLINE
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