Antenatal assessment of liver position, rather than lung-to-head ratio (LHR) or observed/expected LHR, is predictive of outcome in fetuses with isolated left-sided congenital diaphragmatic hernia
| Autor: | Ladislav Krofta, Jaroslav Feyereisl, Jiří Vojtěch, Pýcha K, Zbyněk Straňák, Michal Rygl, L.A. Haak, Luboš Hašlík |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Polyhydramnios Birth weight Prenatal diagnosis Gestational Age Ultrasonography Prenatal 03 medical and health sciences 0302 clinical medicine Pregnancy 030225 pediatrics medicine Humans Survival rate Lung Retrospective Studies Gynecology Fetus 030219 obstetrics & reproductive medicine Obstetrics business.industry Obstetrics and Gynecology Gestational age Congenital diaphragmatic hernia medicine.disease Prognosis Logistic Models Liver In utero Pediatrics Perinatology and Child Health Female business Hernias Diaphragmatic Congenital Head |
| Zdroj: | The journal of maternal-fetalneonatal 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. 30(1) |
| ISSN: | 1476-4954 |
| Popis: | Respiratory morbidity in congenital diaphragmatic hernia (CDH) is associated with high mortality and adverse outcome. Accurate prenatal diagnosis is essential for prognosis and potential treatment in utero. The aim was to evaluate the prenatal ultrasound findings in assessing the respiratory prognosis in fetuses with isolated left-sided CDH.We retrospectively analyzed the medical records of 59 prenatally diagnosed left-sided CDH cases managed at a tertiary perinatal center.Survival rate in the study group was 73% (43/59). We found no statistically significant relationship between survival and the presence of polyhydramnios, gestational age at diagnosis, lung-to-head ratio (LHR) and observed/expected LHR (O/E LHR) values, gestational age at birth and birth weight. Intrathoracic liver herniation was a statistically significant parameter adversely affecting survival (37.2% in survivors, 68.8% in non-survivors, p = 0.031) and logistic regression confirmed this relationship. The presence of pneumothorax and severe pulmonary hypertension were significantly associated with mortality (82% non-survivors versus 15% in survivors, p = 0.0001).Intrathoracic liver herniation seems to be a reliable parameter in the prediction of survival and neonatal respiratory morbidity in fetuses with isolated left-sided CDH. In contrast, we found no significant correlation between perinatal outcome and LHR, O/E LHR values, birth weight and gestational age. |
| Databáze: | OpenAIRE |
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