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Research: Prenatal stomach position and volume in relation to postnatal outcomes in left-sided congenital diaphragmatic hernia

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Research: Prenatal stomach position and volume in relation to postnatal outcomes in left-sided congenital diaphragmatic hernia

Prenat Diagn

. 2021 Jul 22. doi: 10.1002/pd.6019. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/34292626/

Prenatal stomach position and volume in relation to postnatal outcomes in left-sided congenital diaphragmatic hernia

Katinka Weller 1Nina C J Peters 1Joost van Rosmalen 2 3Suzan C M Cochius-Den Otter 4Philip L J DeKoninck 1Rene M H Wijnen 4Titia E Cohen-Overbeek 1Alex J Eggink 1Affiliations expand

Abstract

Objective: To examine the association between prenatal stomach position (SP) grade and stomach volume (SV) and the need for pulmonary hypertension (PH) treatment after birth in prenatally diagnosed left-sided congenital diaphragmatic hernia (CDH), live born >34 weeks.

Methods: In retrospect, SP grade and SV were determined in fetuses with isolated left-sided CDH from 19 weeks gestational age (GA) onwards at three different time periods (≤24 weeks’ GA: US1, 24-30 weeks’ GA: US2; ≥30 weeks’ GA: US3). Primary outcome was need for treatment of PH after birth. Secondary analyses included the predictive value of SP and SV for other respiratory outcomes and postnatal defect size.

Results: A total of 101 fetuses were included. SP grade was significantly associated with need for treatment of PH (US1, US2 and US3: p<0.02). Also, prenatal SP grade was positively associated with defect size and development of chronic lung disease in survivors. No association was found between SV and respiratory morbidities or postnatal defect size.

Conclusion: SP grade in left-sided CDH fetuses is associated with an increased need for PH treatment, a larger postnatal defect size and chronic lung disease in survivors. We consider SP determination a valuable contribution to the prenatal assessment of left-sided CDH. This article is protected by copyright. All rights reserved.

Keywords: Congenital diaphragmatic hernia; postnatal defect size; pulmonary hypertension; stomach position.

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