Arch Gynecol Obstet
. 2023 Oct 3.
doi: 10.1007/s00404-023-07215-1. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/37789206/
Fetal surgery using fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia: a single-center experience
Ana Idelson 1, Kinneret Tenenbaum-Gavish 1 2, David Danon 1 2, Nir-Ram Duvdevani 1, Ruben Bromiker 2 3, Gil Klinger 2 3, Sharon Orbach-Zinger 2 4, Anastasia Almog 2 5, Adi Sharabi-Nov 6, Hamutal Meiri 7, Kypros H Nicolaides 8, Arnon Wiznitzer 1 2, Yuval Gielchinsky 9 10
- PMID: 37789206
- DOI: 10.1007/s00404-023-07215-1
Purpose: To provide a comprehensive report of the experience gained in the prenatal treatment of congenital diaphragmatic hernia (CDH) using fetoscopic endoluminal tracheal occlusion (FETO) following its implementation at a newly established specialized fetal medicine center.
Methods: Mothers of fetuses with severe CDH were offered prenatal treatment by FETO.
Results: Between 2018 and 2021, 16 cases of severe CDH underwent FETO. The median gestational age (GA) at balloon insertion was 28.4 weeks (IQR 27.8-28.6). The median GA at delivery was 37 weeks (IQR 34.4-37.8). The survival rate was 8/16 cases (50%). None of the survivors required home oxygen therapy at 6 months of age. Comparison between the survivors and deceased showed that survivors had balloon insertion 1 week earlier (27.8 vs. 28.4 weeks, p = 0.007), a higher amniotic fluid level change between pre- to post-FETO (3.4 vs 1.3, p = 0.024), a higher O/E LHR change between pre- to post-FETO (50.8 vs. 37.5, p = 0.047), and a GA at delivery that was 2 weeks later (37.6 vs. 35.4 weeks, p = 0.032).
Conclusions: The survival rate at 6 months of age in cases of severe CDH treated with FETO in our center was 50%. Our new fetal medicine center matches the performance of other leading international centers.
Keywords: Congenital diaphragmatic hernia (CDH); FETO; Fetal surgery; Fetal therapy; Fetoscopy.
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.