Fetal pulmonary artery diameters and their association with lung hypoplasia and postnatal outcome in congenital diaphragmatic hernia
| Autor: | Derek Stephens, Marlene Rabinovitch, Jennifer Sokol, G. Greg Ryan, Jeffrey F. Smallhorn, Ronald V. Lacro, Lisa K. Hornberger, Desmond Bohn |
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| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Diaphragmatic breathing Pulmonary Artery Ultrasonography Prenatal Embryonic and Fetal Development Fetus Internal medicine medicine.artery medicine Respiratory muscle Humans Lung Retrospective Studies Hernia Diaphragmatic medicine.diagnostic_test business.industry Respiratory disease Infant Newborn Obstetrics and Gynecology Congenital diaphragmatic hernia Abortion Induced Organ Size medicine.disease Survival Analysis Hypoplasia Surgery medicine.anatomical_structure Echocardiography Pulmonary artery Cardiology Hernias Diaphragmatic Congenital business Fetal echocardiography |
| Zdroj: | American Journal of Obstetrics and Gynecology. 186:1085-1090 |
| ISSN: | 0002-9378 |
| DOI: | 10.1067/mob.2002.122413 |
| Popis: | Objective: We hypothesized that fetal branch pulmonary artery (PA) diameters indirectly reflect lung mass and are associated with postnatal outcome in cases of isolated congenital diaphragmatic hernia (CDH). Study Design: We retrospectively reviewed echocardiograms of fetuses with CDH, measuring branch PA diameters and other echocardiographic parameters. Antenatal parameters were correlated with postmortem lung weights in 5 fetuses after pregnancy termination. Fetal echocardiographic measures were correlated with outcome variables in 29 live-born infants with CDH to identify antenatal indices associated with postnatal death and respiratory morbidity. Results: Antenatal branch PA size correlated with postmortem lung weights from 5 terminated fetuses ( r = 0.87). In 26 cases of left CDH in which the fetus continued to term, the ipsilateral branch PA diameter was significantly smaller than the contralateral branch PA diameter at presentation ( P P =.049). Among survivors with left CDH, the main PA z score and the discrepancy between right and left PA diameters correlated positively with duration of supplemental oxygen requirement ( P =.019 and P =.022, respectively) and ventilation ( P =.036 and P =.012, respectively). Serial antenatal studies in 8 of 10 cases revealed progressive ipsilateral PA hypoplasia. Conclusion: Antenatal branch PA size correlates with postmortem lung weight. A larger contralateral PA, and significant branch PA discrepancy and larger main PA diameter, best correlate with postnatal death and respiratory morbidity, respectively. Progressive ipsilateral PA hypoplasia suggests progressive in utero lung hypoplasia in cases of CDH. (Am J Obstet Gynecol 2002;186:1085-90.) |
| Databáze: | OpenAIRE |
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