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Prenatal sonographic chest and lung measurements for predicting severe pulmonary hypoplasia
Author(s) -
Merz Eberhard,
MiricTesanic Danka,
Bahlmann Franz,
Weber Gerald,
Hallermann Christian
Publication year - 1999
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/(sici)1097-0223(199907)19:7<614::aid-pd595>3.0.co;2-p
Subject(s) - pulmonary hypoplasia , medicine , hypoplasia , diaphragmatic hernia , congenital diaphragmatic hernia , lung , gestational age , thorax (insect anatomy) , gestation , fetus , surgery , anatomy , hernia , pregnancy , genetics , biology
Pulmonary hypoplasia was diagnosed sonographically in 32 fetuses from 20 to 33 weeks of gestation. In addition to standard biometry, transverse thoracic diameter (TTD), sagittal thoracic diameter (TSD), thoracic circumference (TC) and lung diameter (LD) were measured in all cases and compared with known nomograms. The fetuses were divided into five groups according to the main sonographic findings: group 1—skeletal dysplasia; group 2—renal agenesis; group 3—diaphragmatic hernia; group 4—hydrothorax; and group 5—others. Severe pulmonary hypoplasia (PH) was diagnosed prenatally in all cases on the basis of LD measurements. In 17 (53.1 per cent) out of 32 cases TTD was below the 5th percentile while lower TSD measurements were recorded in 15 (46.8 per cent) fetuses. A thorax circumference below the 5th percentile for the respective gestational age was found in 15 cases (46.8 per cent) and a decreased LD/TC ratio in 25 cases (78.1 per cent). In 13 out of 32 fetuses pulmonary hypoplasia was diagnosed before, and in 19 cases after 24 weeks of gestation. Pulmonary hypoplasia was confirmed by autopsy in all cases. Conclusion: pulmonary hypoplasia can be sonographically detected before 24 weeks of gestation. In cases of skeletal dysplasia and renal agenesis pulmonary hypoplasia can be diagnosed by chest and lung measurements, whereas in diaphragmatic hernia and hydrothorax diagnosis of pulmonary hypoplasia is possible only by lung measurement. Copyright © 1999 John Wiley & Sons, Ltd.