Longitudinal assessment of lung area measurements by two-dimensional ultrasound in fetuses with isolated left-sided congenital diaphragmatic hernia

Rodrigo Ruano, I. S.W. Britto, H. Sangi-Haghpeykar, L. C.S. Bussamra, M. M. Da Silva, M. A. Belfort, R. L. Deter, W. Lee, U. Tannuri, M. Zugaib

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective To evaluate lung growth in healthy fetuses and those with congenital diaphragmatic hernia (CDH) using two-dimensional (2D) ultrasound. Methods Fetal right lung measurements obtained by 2D ultrasound between 19 and 37 weeks' gestation were evaluated longitudinally in 66 healthy fetuses and 52 fetuses with isolated left-sided CDH. Right lung areas were determined by the 'tracing' and 'longest-diameters' methods and, subsequently, lung area-to-head circumference ratios (LHRs) were calculated. Functions fitted to these size parameters with respect to gestational age were evaluated for three sets of group-wise comparisons: (1) healthy vs CDH fetuses; (2) different degrees of severity of CDH; and (3) CDH fetuses that survived vs those that died by 6 months postpartum. Results There was a significantly slower increase in right lung areas and LHRs with advancing gestational age in CDH fetuses than in healthy individuals (P < 0.05). Compared to those with milder forms of CDH, lung areas and LHRs of fetuses with more severe forms displayed a smaller increase (P < 0.05) and LHRs of fetuses with severe CDH did not increase during pregnancy (P > 0.05). Individuals who died postpartum did not show any increase in LHR (P > 0.05) throughout gestation. Conclusions The right lung area and LHR, calculated using either the longest-diameters or tracing method, display reduced growth rates during gestation in cases of isolated left-sided CDH as compared with healthy fetuses. The growth curve characteristics of fetal lung areas and LHRs may be useful for predicting neonatal mortality.

Original languageEnglish (US)
Pages (from-to)566-571
Number of pages6
JournalUltrasound in Obstetrics and Gynecology
Volume45
Issue number5
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Fetus
Lung
Pregnancy
Postpartum Period
Gestational Age
Growth
Infant Mortality
Congenital Diaphragmatic Hernias
Head

Keywords

  • congenital diaphragmatic hernia
  • fetal lung
  • fetal lung area
  • lung-to-head ratio
  • prenatal diagnosis
  • pulmonary hypoplasia
  • ultrasound

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

Cite this

Longitudinal assessment of lung area measurements by two-dimensional ultrasound in fetuses with isolated left-sided congenital diaphragmatic hernia. / Ruano, Rodrigo; Britto, I. S.W.; Sangi-Haghpeykar, H.; Bussamra, L. C.S.; Da Silva, M. M.; Belfort, M. A.; Deter, R. L.; Lee, W.; Tannuri, U.; Zugaib, M.

In: Ultrasound in Obstetrics and Gynecology, Vol. 45, No. 5, 01.01.2015, p. 566-571.

Research output: Contribution to journalArticle

Ruano, R, Britto, ISW, Sangi-Haghpeykar, H, Bussamra, LCS, Da Silva, MM, Belfort, MA, Deter, RL, Lee, W, Tannuri, U & Zugaib, M 2015, 'Longitudinal assessment of lung area measurements by two-dimensional ultrasound in fetuses with isolated left-sided congenital diaphragmatic hernia', Ultrasound in Obstetrics and Gynecology, vol. 45, no. 5, pp. 566-571. https://doi.org/10.1002/uog.13420
Ruano, Rodrigo ; Britto, I. S.W. ; Sangi-Haghpeykar, H. ; Bussamra, L. C.S. ; Da Silva, M. M. ; Belfort, M. A. ; Deter, R. L. ; Lee, W. ; Tannuri, U. ; Zugaib, M. / Longitudinal assessment of lung area measurements by two-dimensional ultrasound in fetuses with isolated left-sided congenital diaphragmatic hernia. In: Ultrasound in Obstetrics and Gynecology. 2015 ; Vol. 45, No. 5. pp. 566-571.
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abstract = "Objective To evaluate lung growth in healthy fetuses and those with congenital diaphragmatic hernia (CDH) using two-dimensional (2D) ultrasound. Methods Fetal right lung measurements obtained by 2D ultrasound between 19 and 37 weeks' gestation were evaluated longitudinally in 66 healthy fetuses and 52 fetuses with isolated left-sided CDH. Right lung areas were determined by the 'tracing' and 'longest-diameters' methods and, subsequently, lung area-to-head circumference ratios (LHRs) were calculated. Functions fitted to these size parameters with respect to gestational age were evaluated for three sets of group-wise comparisons: (1) healthy vs CDH fetuses; (2) different degrees of severity of CDH; and (3) CDH fetuses that survived vs those that died by 6 months postpartum. Results There was a significantly slower increase in right lung areas and LHRs with advancing gestational age in CDH fetuses than in healthy individuals (P < 0.05). Compared to those with milder forms of CDH, lung areas and LHRs of fetuses with more severe forms displayed a smaller increase (P < 0.05) and LHRs of fetuses with severe CDH did not increase during pregnancy (P > 0.05). Individuals who died postpartum did not show any increase in LHR (P > 0.05) throughout gestation. Conclusions The right lung area and LHR, calculated using either the longest-diameters or tracing method, display reduced growth rates during gestation in cases of isolated left-sided CDH as compared with healthy fetuses. The growth curve characteristics of fetal lung areas and LHRs may be useful for predicting neonatal mortality.",
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T1 - Longitudinal assessment of lung area measurements by two-dimensional ultrasound in fetuses with isolated left-sided congenital diaphragmatic hernia

AU - Ruano, Rodrigo

AU - Britto, I. S.W.

AU - Sangi-Haghpeykar, H.

AU - Bussamra, L. C.S.

AU - Da Silva, M. M.

AU - Belfort, M. A.

AU - Deter, R. L.

AU - Lee, W.

AU - Tannuri, U.

AU - Zugaib, M.

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Y1 - 2015/1/1

N2 - Objective To evaluate lung growth in healthy fetuses and those with congenital diaphragmatic hernia (CDH) using two-dimensional (2D) ultrasound. Methods Fetal right lung measurements obtained by 2D ultrasound between 19 and 37 weeks' gestation were evaluated longitudinally in 66 healthy fetuses and 52 fetuses with isolated left-sided CDH. Right lung areas were determined by the 'tracing' and 'longest-diameters' methods and, subsequently, lung area-to-head circumference ratios (LHRs) were calculated. Functions fitted to these size parameters with respect to gestational age were evaluated for three sets of group-wise comparisons: (1) healthy vs CDH fetuses; (2) different degrees of severity of CDH; and (3) CDH fetuses that survived vs those that died by 6 months postpartum. Results There was a significantly slower increase in right lung areas and LHRs with advancing gestational age in CDH fetuses than in healthy individuals (P < 0.05). Compared to those with milder forms of CDH, lung areas and LHRs of fetuses with more severe forms displayed a smaller increase (P < 0.05) and LHRs of fetuses with severe CDH did not increase during pregnancy (P > 0.05). Individuals who died postpartum did not show any increase in LHR (P > 0.05) throughout gestation. Conclusions The right lung area and LHR, calculated using either the longest-diameters or tracing method, display reduced growth rates during gestation in cases of isolated left-sided CDH as compared with healthy fetuses. The growth curve characteristics of fetal lung areas and LHRs may be useful for predicting neonatal mortality.

AB - Objective To evaluate lung growth in healthy fetuses and those with congenital diaphragmatic hernia (CDH) using two-dimensional (2D) ultrasound. Methods Fetal right lung measurements obtained by 2D ultrasound between 19 and 37 weeks' gestation were evaluated longitudinally in 66 healthy fetuses and 52 fetuses with isolated left-sided CDH. Right lung areas were determined by the 'tracing' and 'longest-diameters' methods and, subsequently, lung area-to-head circumference ratios (LHRs) were calculated. Functions fitted to these size parameters with respect to gestational age were evaluated for three sets of group-wise comparisons: (1) healthy vs CDH fetuses; (2) different degrees of severity of CDH; and (3) CDH fetuses that survived vs those that died by 6 months postpartum. Results There was a significantly slower increase in right lung areas and LHRs with advancing gestational age in CDH fetuses than in healthy individuals (P < 0.05). Compared to those with milder forms of CDH, lung areas and LHRs of fetuses with more severe forms displayed a smaller increase (P < 0.05) and LHRs of fetuses with severe CDH did not increase during pregnancy (P > 0.05). Individuals who died postpartum did not show any increase in LHR (P > 0.05) throughout gestation. Conclusions The right lung area and LHR, calculated using either the longest-diameters or tracing method, display reduced growth rates during gestation in cases of isolated left-sided CDH as compared with healthy fetuses. The growth curve characteristics of fetal lung areas and LHRs may be useful for predicting neonatal mortality.

KW - congenital diaphragmatic hernia

KW - fetal lung

KW - fetal lung area

KW - lung-to-head ratio

KW - prenatal diagnosis

KW - pulmonary hypoplasia

KW - ultrasound

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