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Research: Prenatal prognostic factors for isolated right congenital diaphragmatic hernia: a single center’s experience

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Research: Prenatal prognostic factors for isolated right congenital diaphragmatic hernia: a single center’s experience

BMC Pediatr

. 2021 Oct 20;21(1):460. doi: 10.1186/s12887-021-02931-6. https://pubmed.ncbi.nlm.nih.gov/34666738/

Prenatal prognostic factors for isolated right congenital diaphragmatic hernia: a single center’s experience

Jiyoon Jeong 1Byong Sop Lee 2Teahyen Cha 1Euiseok Jung 1Ellen Ai-Rhan Kim 1Ki-Soo Kim 1Dae Yeon Kim 3Jung-Man Namgoong 3Seong Chul Kim 3Mi-Young Lee 4Hye-Sung Won 5Affiliations expand

Free PMC article

Abstract

Background: Right-sided congenital diaphragmatic hernia (RCDH) is relatively rare compared with left-sided congenital diaphragmatic hernia (LCDH). Clinical data of RCDH, especially with respect to antenatal prediction of neonatal outcome, are lacking. The aim of this study was to report the treatment outcomes of patients with antenatally diagnosed RCDH and to evaluate the predictability of observed-to-expected lung area-to-head circumference ratio (O/E LHR) for perinatal outcomes, focused on mortality or extracorporeal membrane oxygenation (ECMO) requirement.

Methods: We retrospectively reviewed the medical records of newborn infants with isolated RCDH. We analyzed and compared the clinical and prenatal characteristics including the fetal lung volume, which was measured as the O/E LHR, between the survivors and the non-survivors.

Results: A total of 26 (66.7%) of 39 patients with isolated RCDH survived to discharge. The O/E LHR was significantly greater in survivors (64.7 ± 21.2) than in non-survivors (40.5 ± 23.4) (P =.027). It was greater in survivors without ECMO requirement (68.3 ± 15.1) than non-survivors or those with ECMO requirement (46.3 ± 19.4; P = .010). The best O/E LHR cut-off value for predicting mortality in isolated RCDH was 50.

Conclusions: The findings in this study suggest that O/E LHR, a well-characterized prognostic indicator in LCDH, could be applied to a fetus with antenatally diagnosed RCDH. A large cohort study is required to verify the association between O/E LHR values and the graded severity of RCDH.

Keywords: Congenital diaphragmatic hernia; Extracorporeal membrane oxygenation; Observed-to-expected lung area-to-head circumference ratio; Right-sided congenital diaphragmatic hernia.

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