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Follow-up of fetuses with congenital diaphragmatic hernia: The quantitative lung index

Carlota Rodó1, Tamara Illescas1, Silvia Arévalo1

  • 1Maternal-fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|April 9, 2018
PubMed

Insights

The Quantitative Lung Index (QLI) remained stable during pregnancy for fetuses with congenital diaphragmatic hernia. Lower QLI values were observed in fetuses undergoing tracheal occlusion, indicating its utility in monitoring this condition.

Area of Science:

  • Perinatal medicine
  • Fetal surgery
  • Medical imaging

Background:

  • Congenital diaphragmatic hernia (CDH) is a severe condition requiring careful fetal monitoring.
  • The Quantitative Lung Index (QLI) is a potential metric for assessing lung development in fetuses with CDH.

Purpose of the Study:

  • To evaluate the longitudinal behavior of the Quantitative Lung Index (QLI) in fetuses diagnosed with congenital diaphragmatic hernia (CDH).
  • To compare QLI performance between fetuses managed with expectant care versus those undergoing tracheal occlusion (TO).

Main Methods:

  • Retrospective analysis of 58 fetuses with isolated left CDH.
  • QLI was calculated from prior lung-to-head ratio (LHR) measurements.
  • A repeated measures mixed-effects model was employed to analyze QLI trends throughout gestation.

Main Results:

  • QLI remained constant throughout pregnancy in both expectant (n=38) and tracheal occlusion (n=20) groups.
  • Fetuses undergoing TO, characterized by LHR <1, o/eLHR ≤45%, and intrathoracic liver, exhibited lower QLI values compared to the non-TO group (p<0.03).
  • Survival rates were 87% for non-TO and 60% for TO groups (p=0.02).

Conclusions:

  • The Quantitative Lung Index (QLI) demonstrates a stable longitudinal behavior during pregnancy in fetuses with CDH.
  • QLI is lower in fetuses selected for tracheal occlusion, suggesting its potential role in risk stratification and management decisions for CDH.
Abstract

Keywords:
Congenital diaphragmatic herniaFetal therapyFetal ultrasoundLung-to-head ratioQuantitative lung index

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