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Research: Prenatal diagnosis of laryngo-tracheo-esophageal anomalies in fetuses with congenital diaphragmatic hernia by ultrasound evaluation of the vocal cords and fetal laryngoesophagoscopy

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Research: Prenatal diagnosis of laryngo-tracheo-esophageal anomalies in fetuses with congenital diaphragmatic hernia by ultrasound evaluation of the vocal cords and fetal laryngoesophagoscopy

Prenat Diagn

. 2020 Aug 2. doi: 10.1002/pd.5806. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/32743809/

Prenatal diagnosis of laryngo-tracheo-esophageal anomalies in fetuses with congenital diaphragmatic hernia by ultrasound evaluation of the vocal cords and fetal laryngoesophagoscopy

Rogelio Cruz-Martínez 1 2 3A Alma Gámez-Varela 1Miguel Martínez-Rodríguez 1 3Jonahtan Luna-García 1Hugo López-Briones 1Eréndira Chavez-González 1Israel Juárez-Martínez 1Areli Razo-Nava 1Rosa Villalobos-Gómez 1César Favela-Heredia 1Affiliations expand

Abstract

Background: To evaluate the incidence of laryngeal ultrasound (US) abnormalities in fetuses with congenital diaphragmatic hernia (CDH) and to assess the utility of fetal laryngoesophagoscopy for prenatal diagnosis of laryngo-tracheo-esophageal anomalies.

Study design: A cohort of CDH fetuses with laryngeal ultrasound abnormalities were selected for diagnostic fetal laringoesophagoscopy in a single fetal surgery center at Queretaro, Mexico.

Results: During the study period, 210 CDH fetuses were evaluated. US examination of the vocal cords was successfully performed in all fetuses and abnormal ultrasound findings were observed in 4 cases (1.9%). Fetal laringoesophagoscopy was successfully performed in all 4 cases at a median gestational age of 29.5 (range, 28.1-30.6) weeks. During fetal intervention, a laryngo-tracheo-esophageal cleft (TEC) extending from the larynx to the carina (type IV) was endoscopically visualized in three cases and laryngeal atresia coexisting with TEC was confirmed in the remaining case. Fetal karyotype was normal in all cases, but abnormal chromosomal microarray analysis was reported in two cases (50%). All cases were delivered liveborn with severe respiratory failure presenting cardiac arrest and immediate neonatal death.

Conclusions: Laryngeal anomalies in CDH fetuses can be presumed by ultrasound evaluation of the vocal cords and confirmed by fetal laryngoesophagoscopy during pregnancy. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

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