Prediction of Mortality and Need for Neonatal Extracorporeal Membrane Oxygenation in Fetuses with Congenital Diaphragmatic Hernia: Logistic Regression Analysis Based on MRI Fetal Lung Volume Measurements

Abstract

Logistic regression analysis of MRI fetal lung volume measurements is highly valuable in predicting mortality among neonates with CDH, and it may help to estimate the need for neonatal ECMO. The method is feasible for facilitating parental guidance and may help in choosing postnatal therapeutic options, including ECMO therapy.

Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging

“…This is in concordance with numerous previous publications on this topic, which investigated the degree of pulmonary hypoplasia on fetal MR imaging and correlated that with the severity of neonatal outcomes [7,9,14,20,22,23,46,47].…”

“…In addition to 2D and 3D ultrasound studies, the potential of MR imaging in the assessment of lung hypoplasia and the prediction of mortality has been validated, and has been shown to be reliable for the prenatal investigation of lung hypoplasia compared with US [5][6][7][8]. Most MR imaging studies have dealt with the volumetric assessment of the lung, where lung volumes were found to be significantly reduced in fetuses with CDH [9,10].…”

Congenital diaphragmatic hernia: does gestational age at diagnosis matter when evaluating morbidity and mortality?

“…Survival rates may reach 80% in centers with a high case load of CDH per year. 7,8 Prenatal management of fetuses with CDH (for instance, fetal surgery by endoscopic tracheal occlusion) as well as postnatal management requires proper evaluation of the prognosis. Pulmonary hypoplasia and persistent pulmonary hypertension are the 2 main determinants of neonatal mortality and morbidity, and new tools have been focused on their evaluation.…”

Fetal Torakal Anomaliler

“…Kalbin dört odasının izlendiği aksiyel kesitte sağ akciğerin ön-arka ve transvers uzunluklarının çarpılması ile bulunan değe-rin, kafa çevresine oranlanmasına "akciğer/ kafa oranı" denir ve kantifikasyon için en sık kullanılan yöntemdir. Bu oran 1'in altındaysa prognozun kötü, 1,6'nın üzerindeyse prognozun iyi olduğunu gösteren birçok çalışma vardır [2,3,14,15]. Fakat eğer karaciğer abdomendeyse bu oranın survi ile bir korelasyonu olmadığı da gösterilmiştir.…”