Prenat Diagn
. 2026 Jul 12.
doi: 10.1002/pd.70222. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/42437363/
Lung Size Measurement in Left-Sided Congenital Diaphragmatic Hernia: Does Position of the Fetus Affect Results?
Rogelio Cruz-Martínez 1, Paola Rivera-Carrillo 1, Rosa Villalobos-Gómez 1, Andrea Peláez-Jiménez 1, Adriana Cisneros-Martínez 1, Savino Gil-Pugliese 2 3, Saulo Molina-Giraldo 4 5
Affiliations Expand
- PMID: 42437363
- DOI: 10.1002/pd.70222
Abstract
Objective: To compare the difference in lung size measurement in fetuses with left-sided congenital diaphragmatic hernia (L-CDH) by means of the observed/expected lung-to-head ratio (O/E-LHR) in two different fetal positions.
Method: Prospective cohort of L-CDH fetuses, with O/E-LHR measurements by one experienced investigator but with the fetus in two positions: with the contralateral lung close and one with the lung away from the ultrasound probe. A Bland-Altman analysis was performed to assess the agreement between lung measurements in both fetal positions.
Results: 49 L-CDH fetuses underwent paired assessments of lung size at a mean gestational age of 28.8 (17.7-37.7) weeks. Lung size estimation with the lung distant to the probe consistently underestimates the O/E-LHR values compared to measurements obtained using the lung close to the probe. On average, O/E-LHR values were 11.3% (95% confidence intervals (CI), 7.5%-15.0%) higher when the lung was close to the probe. When the lung was distant to the probe, a higher proportion of CDH fetuses were classified in a more severe group than when it was evaluated close to the probe (p < 0.01). A consistently lower survival rate was expected when the lung was evaluated distant to the ultrasound probe.
Conclusions: Lung size estimation in L-CDH fetuses may be affected by fetal position, which may affect postnatal prognosis, prediction of survival and eligibility for fetal therapy.
Keywords: LHR; O/E‐LHR; congenital diaphragmatic hernia; lung hypoplasia; lung size; lung‐to‐head ratio; observed/expected lung‐to‐head ratio.
© 2026 John Wiley & Sons Ltd. All rights reserved, including rights for text and data mining and training of artificial intelligence technologies or similar technologies.
About The Author
