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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Predicting perinatal outcome in isolated congenital diaphragmatic hernia using fetal pulmonary artery diameters
Rodrigo Ruano1, Marie-Cécile Aubry, Bruno Barthe
1Université Paris-Descartes, Faculté de Médecine, AP-HP, Maternité, Hôpital Necker-Enfants Malades, 75743 cedex 15, Paris, France. rodrigoruano@hotmail.com
Objective:
The aim of the study was to evaluate the potential of fetal pulmonary artery (PA) diameters to predict perinatal death and pulmonary arterial hypertension (PAH) in congenital diaphragmatic hernia (CDH).
Study Design:
In this prospective observational study, observed PA (main, right, and left) diameters were measured at the level of the 3 vessels in 21 fetuses with isolated CDH and in 85 controls at 22 to 36 weeks. The observed/expected (o/e) diameters of the main, contralateral, and ipsilateral PAs were calculated by comparing these measurements with reference values obtained in our previous study and correlated with perinatal death and postnatal PAH.
Results:
The o/e PA diameters were significantly reduced in fetuses with CDH compared to controls (P < .001) and in fetuses with CDH who died (P < .050). However, there was no significant association between PA diameters and PAH (P >or= .050).
Conclusions:
The PA diameters might be useful to predict perinatal death in isolated CDH but not postnatal PAH, suggesting that PA diameters are probably related to the severity of pulmonary hypoplasia.
