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Liver position is a prenatal predictive factor of prosthetic repair in congenital diaphragmatic hernia
Shaun M Kunisaki1, Carol E Barnewolt, Judy A Estroff
1Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
Objective:
To determine whether any common maternal-fetal variable has prenatal predictive value of prosthetic repair in congenital diaphragmatic hernia.
Methods:
This was a 5-year single-center retrospective review of fetal congenital diaphragmatic hernia referrals. Multiple prenatal variables were correlated with the need for a prosthetic repair. Statistical analyses were by Fisher's exact and Mann-Whitney U-tests, as appropriate (p < 0.05).
Results:
Fetal liver position was a predictor of prosthetic repair. The presence or absence of liver herniation was correlated with prosthetic repair rates of 83.3 and 23.1%, respectively (p < 0.001). All patients with moderate/severe liver herniation required a prosthetic patch.
Conclusion:
Liver herniation has prenatal predictive value for the need for prosthetic repair in congenital diaphragmatic hernia. This finding should be valuable during prenatal counseling for clinical trials of engineered diaphragmatic repair.
