| Contribution of intrapulmonary artery Doppler to improve prediction of survival in fetuses with congenital diaphragmatic hernia treated with fetal endoscopic tracheal occlusion | ||
| Presented by Dr. Preethi | ||
| Cruz-Martinez, O. Moreno-Alvarez, E. Hernandez-Andrade,
M. Castanon, E. Done, J.M. Martinez, B. Puerta, J. Deprest, E. Gratacos Ultrasound Obstet Gynecol 2010; 35: 572-57 |
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| Objective | ||
To evaluate the contribution of intrapulmonary artery
doppler in predicting the survival of fetuses with congenital diaphragmatic
hernia (CDH) treated eith fetoscopic tracheal occlusion (FETO). |
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| Methods | ||
A cohort of 41 fetuses (between 24-28 weeks of gestation)
with CDH was treated with FETO. The observed /Expected lung head ratio
(O/E LHR), pulmonary artery pulsatility index(PI), peak early diastolic
reversed flow (PEDRF) and peak systolic velocity(PSV) were evaluated before
FETO, and their isolated and combined value to predict survival using
multiple logistic regression and decision-tree analysis was assessed. |
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| Results | ||
O/E LHR and intrapulmonary artery PI and PEDRF were
significantly associated with the probability of survival (O/E) LHR >/=
26%, 90% survival; O/E LHE <26%, 45% survival). For fetuses with an
O/E LHE of <26%, Doppler parameters allowed discrimination of cases
with moderate (66-71% survival) and very poor (0% survival) prognosis. |
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| Conclusions | ||
| Intrapulmonary artery Doppler evaluation helps to
refine the prediction of survival after FETO in fetuses with severe CDH. |
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