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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
| Content Provider | Scilit |
|---|---|
| Author | Straňák, Zbyněk Krofta, Ladislav Haak, Lucia Anna Vojtěch, Jiří Hašlík, Luboš Rygl, Michal Pýcha, Karel Feyereisl, Jaroslav |
| Copyright Year | 2016 |
| Description | Objectives: 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. Methods: We retrospectively analyzed the medical records of 59 prenatally diagnosed left-sided CDH cases managed at a tertiary perinatal center. Results: 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). Conclusion: 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. |
| Related Links | https://www.tandfonline.com/doi/pdf/10.3109/14767058.2016.1163539 |
| Ending Page | 78 |
| Page Count | 5 |
| Starting Page | 74 |
| ISSN | 14767058 |
| e-ISSN | 14764954 |
| DOI | 10.3109/14767058.2016.1163539 |
| Journal | The Journal of Maternal-Fetal & Neonatal Medicine |
| Issue Number | 1 |
| Volume Number | 30 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2017-01-02 |
| Access Restriction | Open |
| Subject Keyword | Journal: The Journal of Maternal-fetal & Neonatal Medicine Pediatrics and Child Health Congenital Diaphragmatic Hernia Prenatal Diagnosis Outcome Respiratory Morbidity |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pediatrics, Perinatology and Child Health Obstetrics and Gynecology |
