Fetal lung volume after endoscopic tracheal occlusion in the prediction of postnatal outcome

Am J Obstet Gynecol. 2008 Jan;198(1):60.e1-5. doi: 10.1016/j.ajog.2007.05.034. Epub 2007 Sep 12.

Abstract

Objective: The objective of the study was to investigate the volume response of the contralateral lung in the prediction of postnatal outcome in fetuses with congenital diaphragmatic hernia (CDH) treated by fetoscopic endotracheal occlusion (FETO).

Study design: In 30 fetuses with isolated severe CDH that underwent FETO, the volume of the contralateral lung was measured by 3-dimensional ultrasound the day before and 2 and 7 days after FETO. The measurements of fetuses that subsequently died were compared to those who survived.

Results: In all fetuses before FETO, the lung volume was below the 2.5th percentile of the normal range for gestation (60%). Within 2 days after FETO, the lung volume increased to above the 2.5th percentile in 14/21 (66%) that survived, compared with 1/9 (11%) that died. The respective percentages at 7 days after FETO were 95% and 11%, respectively.

Conclusion: In fetuses with CDH, the lung responsiveness within 2 and 7 days after FETO provides useful prediction of subsequent survival.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Endoscopy / methods
  • Female
  • Fetal Death
  • Fetal Diseases / diagnostic imaging
  • Fetal Diseases / surgery
  • Fetal Organ Maturity
  • Fetoscopy / methods*
  • Fetoscopy / mortality
  • Follow-Up Studies
  • Gestational Age
  • Hernia, Diaphragmatic / diagnostic imaging
  • Hernia, Diaphragmatic / mortality*
  • Hernia, Diaphragmatic / surgery*
  • Humans
  • Infant Mortality / trends
  • Infant, Newborn
  • Lung / embryology*
  • Lung / growth & development
  • Lung Volume Measurements
  • Pregnancy
  • Probability
  • Prospective Studies
  • ROC Curve
  • Risk Assessment
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Trachea
  • Treatment Outcome
  • Ultrasonography, Prenatal*