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Updated: Apr 2, 2026
Murine Fetal Echocardiography
Published on: February 15, 2013
Cardiac fetal ultrasonographic parameters for predicting outcomes of isolated left-sided congenital diaphragmatic
Masaya Yamoto1, Yasuhiko Tanaka2, Koji Fukumoto1
1Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
Insights
Fetal cardiac ultrasound measurements can predict outcomes for isolated left-sided congenital diaphragmatic hernia (CDH). The tricuspid valve to mitral valve (TV/MV) ratio is a reliable indicator for survival in CDH patients.
Area of Science:
- Perinatology
- Fetal Cardiology
- Congenital Anomalies
Background:
- Isolated left-sided congenital diaphragmatic hernia (CDH) presents significant challenges in predicting fetal outcomes.
- Fetal cardiac ultrasonography offers potential for non-invasive assessment of cardiac function and structure.
Purpose of the Study:
- To investigate fetal cardiac ultrasonographic parameters in relation to outcomes of isolated left-sided CDH.
- To identify specific echocardiographic markers that correlate with survival in fetuses diagnosed with CDH.
Main Methods:
- Comparison of cardiothoracic area ratio (CTAR), main pulmonary artery to ascending aorta diameter ratio (MPA/AAo), and tricuspid valve to mitral valve diameter ratio (TV/MV) between CDH fetuses and controls.
- Analysis of these parameters in relation to survival (SG) and non-survival (NSG) groups within the CDH cohort.
Main Results:
- All three ultrasonographic parameters (CTAR, MPA/AAo, TV/MV) differed significantly between CDH fetuses and controls.
- CTAR and TV/MV ratios showed significant differences between survival and non-survival groups.
- A TV/MV ratio >1.72 effectively discriminated between survivors and non-survivors, with increasing TV/MV ratio correlating with gestational age.
Conclusions:
- Fetal cardiac ultrasonography is a valuable tool for predicting outcomes in isolated left-sided CDH.
- The TV/MV ratio emerges as a reliable indicator for assessing the prognosis of fetuses with isolated left-sided CDH.
Background:
The purpose of this study was to investigate fetal cardiac ultrasonographic parameters in relation to the outcomes of patients with isolated left-sided congenital diaphragmatic hernia (CDH).
Methods:
Subjects comprised 33 fetuses with fetal CDH and 99 control fetuses without cardiac and lung anomalies. Three parameters, cardiothoracic area ratio (CTAR), the ratio of the diameter of the main pulmonary artery to that of the ascending aorta (MPA/AAo), and the ratio of the diameter of the tricuspid valve to that of the mitral valve (TV/MV) were compared between fetal CDH and control subjects and between survival (SG) and non-survival (NSG) groups.
Results:
All three parameters differed significantly between CDH and control fetuses. Significant differences between SG and NSG were observed in CTAR and TV/MV ratio, but not in MPA/AAo ratio before and after 32 gestational weeks. A significant increase in the TV/MV ratio was noted along with an increase in gestational age. A TV/MV ratio of >1.72 discriminated non-survivors from survivors with better sensitivity and specificity.
Conclusions:
Fetal cardiac ultrasonography provides useful information for predicting the outcomes of isolated left-sided CDH. The TV/MV ratio was considered a reliable indicator that reflected outcomes of isolated left-sided CDH.
