Reliability of the lung to thorax transverse area ratio as a predictive parameter in fetuses with congenital diaphragmatic hernia

Noriaki Usui, Yoshihiro Kitano, Hiroomi Okuyama, Mari Saito, Nobuyuki Morikawa, Hajime Takayasu, Tomoo Nakamura, Satoshi Hayashi, Motoyoshi Kawataki, Hiroshi Ishikawa, Keisuke Nose, Noboru Inamura, Kouji Masumoto, Haruhiko Sago

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Purpose: An accurate prenatal assessment of the patients' severity is essential for the optimal treatment of individuals with congenital diaphragmatic hernia (CDH). The purpose of this study was to clarify the reliability of the lung to thorax transverse area ratio (L/T) as a prenatal predictive parameter. Methods: A multicenter retrospective cohort study was conducted on 114 isolated CDH fetuses with a prenatal diagnosis during the period between 2002 and 2007 at five participating centers in Japan. The relationship between the gestational age and the L/T was analyzed. The most powerful measurement point and accurate cutoff value of the L/T was determined by an analysis of a receiver operating characteristic curve, which was verified by comparing the patients' severity. Results: There was a negative correlation between the gestational age and the L/T in the non-survivors, and no correlation in the survivors. There were significant differences in the parameters which represented the patients' severity including the respiratory and circulatory status, the surgical findings, and the final outcomes between the groups divided at 0.080 in the minimum value of the L/T during gestation. Conclusion: The L/T was not strongly influenced by the gestational age, and it was found to be a reliable prenatal predictive parameter in fetuses with isolated CDH.

Original languageEnglish
Pages (from-to)39-45
Number of pages7
JournalPediatric Surgery International
Volume27
Issue number1
DOIs
Publication statusPublished - 2011 Jan

Keywords

  • Congenital diaphragmatic hernia
  • Predictive parameter
  • Prenatal diagnosis
  • Prognostic factor
  • Pulmonary hypertension
  • Severity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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