Longitudinal assessment of lung area measurements by two‐dimensional ultrasound in fetuses with isolated left‐sided congenital diaphragmatic hernia

Abstract

Objective To evaluate lung growth in healthy fetuses and those with congenital diaphragmatic hernia (CDH) using two-dimensional (2D) ultrasound. Methods

Longitudinal changes in lung size and intrapulmonary‐artery Doppler during the second half of pregnancy in fetuses with congenital diaphragmatic hernia

“…In a previous study, Ruano et al attempted to evaluate longitudinal behavior of lung size in a cohort of 52 isolated left‐sided CDH fetuses and 66 healthy fetuses without congenital malformations and found different lung growth patterns between study groups. The CDH group showed a reduced lung growth rate and a progressive deterioration of lung size throughout pregnancy as compared with the control group.…”

“…Similarly, the proportion of abnormal IPa Doppler parameters at diagnosis and at last examination before delivery was significantly higher in nonsurvivors than survivors ( Figure 5). Logistic regression analysis showed that O/E-LHR, liver position, and intrapulmonary-artery Doppler indices were significantly In a previous study, Ruano et al 19 attempted to evaluate longitudinal behavior of lung size in a cohort of 52 isolated left-sided CDH fetuses and 66 healthy fetuses without congenital malformations and found different lung growth patterns between study groups. The CDH group showed a reduced lung growth rate and a progressive deterioration of lung size throughout pregnancy as compared with the control group.…”

“…In addition, Doppler evaluation of fetal lung circulation has been suggested to be a surrogate of intrapulmonary‐artery resistance, allowing stratification of CDH cases with high risk to develop severe neonatal pulmonary hypertension, neonatal morbidity, and mortality . Preliminary evidence has demonstrated that CDH fetuses show a different lung growth rate during pregnancy in comparison with healthy fetuses and that such lung growth pattern could be of clinical benefit in refining the postnatal prognosis . Similarly, longitudinal changes in intrapulmonary blood flow of CDH fetuses have been partially investigated by three‐dimensional power Doppler ultrasonography .…”

“…18 Preliminary evidence has demonstrated that CDH fetuses show a different lung growth rate during pregnancy in comparison with healthy fetuses and that such lung growth pattern could be of clinical benefit in refining the postnatal prognosis. 19 Similarly, longitudinal changes in intrapulmonary blood Presented at the 17th World Congress in Fetal Medicine, Athens, Greece, June 24-28, 2018. flow of CDH fetuses have been partially investigated by threedimensional power Doppler ultrasonography. 15 However, contrary to two-dimensional spectral Doppler indices, the 3D pulmonary vascularization indices are more difficult to implement for clinical practice, and therefore, they cannot be used for parental counseling.…”

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“…Whether this is an independent predictor remains uncertain. Others suggest using serial measurements for prognostication, but this may not be practical . Far less is known about the uncommon right‐sided CDH; however lung size, determined by US or MR, seems to be predictive, but the values for severity of hypoplasia used for left‐sided lesions cannot be interchanged with those used for right‐sided lesions .…”