Three-dimensional ultrasonographic measurements of the fetal lungs for prediction of perinatal outcome in isolated congenital diaphragmatic hernia

Rodrigo Ruano, Marie Cécile Aubry, Bruno Barthe, Yves Dumez, Alexandra Benachi

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Aim: To evaluate the potential of different lung measurements using three-dimensional ultrasonography (3D-US) to predict perinatal outcome in isolated congenital diaphragmatic hernia (CDH). Methods: Twenty-one fetuses presenting isolated CDH were prospectively evaluated by 3D-US between January 2002 and November 2003. Observed/expected total, contralateral and ipsilateral fetal lung volume ratios (o/e-TotFLV, o/e-ContFLV and o/e-IpsiFLV, respectively) were calculated using the rotational technique and ultrasonographic fetal total lung volume to bodyweight ratio (USFLW). These lung measurements were compared to each other and to perinatal outcomes: perinatal deaths, severe pulmonary hypoplasia (PH) and pulmonary arterial hypertension (PAH). Results: Perinatal death occurred in 11 of the 21 infants (52.4%), severe PH in 14 of 21 infants (66.7%) and PAH in 14 of 20 neonates (70%). Severe PH and PAH occurred simultaneously in 12 of 20 (60%) infants. Good correlations between lung ratios were observed. O/e-TotFLV, o/e-IpsiFLV and USFLW correlated statistically with postnatal diagnosis of severe PH, while only o/e-TotFLH correlated statistically with postnatal diagnosis of PAH. The accuracies of o/e-TotFLV, o/e-ContFLV, o/e-IpsiFLV and USFLW in predicting perinatal deaths were 85.7, 76.2, 66.7 and 76.2%, respectively. Conclusion: O/e-TotFLV using 3D-US appears to be the most accurate predictor of perinatal mortality because it can predict both PH and PAH.

Original languageEnglish (US)
Pages (from-to)1031-1041
Number of pages11
JournalJournal of Obstetrics and Gynaecology Research
Volume35
Issue number6
DOIs
StatePublished - Dec 1 2009
Externally publishedYes

Fingerprint

Lung
Pulmonary Hypertension
Congenital Diaphragmatic Hernias
Perinatal Mortality
Ultrasonography
Fetus
Newborn Infant
Perinatal Death

Keywords

  • 3-D ultrasound
  • Congenital diaphragmatic hernia
  • Fetal lung
  • Prenatal diagnosis
  • Pulmonary hypoplasia
  • Ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Three-dimensional ultrasonographic measurements of the fetal lungs for prediction of perinatal outcome in isolated congenital diaphragmatic hernia. / Ruano, Rodrigo; Aubry, Marie Cécile; Barthe, Bruno; Dumez, Yves; Benachi, Alexandra.

In: Journal of Obstetrics and Gynaecology Research, Vol. 35, No. 6, 01.12.2009, p. 1031-1041.

Research output: Contribution to journalArticle

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abstract = "Aim: To evaluate the potential of different lung measurements using three-dimensional ultrasonography (3D-US) to predict perinatal outcome in isolated congenital diaphragmatic hernia (CDH). Methods: Twenty-one fetuses presenting isolated CDH were prospectively evaluated by 3D-US between January 2002 and November 2003. Observed/expected total, contralateral and ipsilateral fetal lung volume ratios (o/e-TotFLV, o/e-ContFLV and o/e-IpsiFLV, respectively) were calculated using the rotational technique and ultrasonographic fetal total lung volume to bodyweight ratio (USFLW). These lung measurements were compared to each other and to perinatal outcomes: perinatal deaths, severe pulmonary hypoplasia (PH) and pulmonary arterial hypertension (PAH). Results: Perinatal death occurred in 11 of the 21 infants (52.4{\%}), severe PH in 14 of 21 infants (66.7{\%}) and PAH in 14 of 20 neonates (70{\%}). Severe PH and PAH occurred simultaneously in 12 of 20 (60{\%}) infants. Good correlations between lung ratios were observed. O/e-TotFLV, o/e-IpsiFLV and USFLW correlated statistically with postnatal diagnosis of severe PH, while only o/e-TotFLH correlated statistically with postnatal diagnosis of PAH. The accuracies of o/e-TotFLV, o/e-ContFLV, o/e-IpsiFLV and USFLW in predicting perinatal deaths were 85.7, 76.2, 66.7 and 76.2{\%}, respectively. Conclusion: O/e-TotFLV using 3D-US appears to be the most accurate predictor of perinatal mortality because it can predict both PH and PAH.",
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AU - Benachi, Alexandra

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KW - Prenatal diagnosis

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KW - Ultrasound

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