Objectives

Objective To evaluate the contribution of intrapulmonary artery Doppler in predicting the survival of fetuses with congenital diaphragmatic hernia (CDH) treated with fetoscopic tracheal occlusion (FETO). Methods A cohort of 41 fetuses (between 24 and 28 weeks of gestation) with CDH was treated with FETO. The observed/expected lung-to-head ratio (O/E-LHR), pulmonary artery pulsatility index (PI), peak early diastolic reversed flow (PEDRF) and peak systolic velocity (PSV) were evaluated before FETO, and their isolated and combined value to predict survival using multiple logistic regression and decision-tree analysis was assessed. OR 8.4; OR 5.7). Results O/E-LHR and intrapulmonary artery PI and PEDRF were significantly associated with the probability of survival (O/E-LHR ≥ 26%, OR 14.2; PI < 1 Decision-tree analysis showed that O/E-LHR was the best initial predictor of prognosis (O/E-LHR ≥ 26%, 90% survival; O/E-LHR < 26%, 45% survival). For fetuses with an O/E-LHR of