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Prenatal cerebellar growth is altered in congenital diaphragmatic hernia on ultrasound
Author(s) -
Van der Veeken Lennart,
Russo Francesca M.,
Litwinska Ewelina,
Gomez Olga,
Emam Doaa,
Lewi Liesbeth,
Basurto David,
Van der Veeken Stephan,
De Catte Luc,
Gratacos Eduard,
Eixarch Elisenda,
Nicolaides Kypros,
Deprest Jan
Publication year - 2022
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/pd.5993
Subject(s) - medicine , congenital diaphragmatic hernia , middle cerebral artery , gestational age , fetus , gestation , ultrasound , cardiology , diaphragmatic breathing , pregnancy , radiology , ischemia , pathology , genetics , alternative medicine , biology
Abstract Objective Children with congenital diaphragmatic hernia (CDH) are at risk for neurodevelopmental delay. Herein we report on prenatal changes in biometry and brain perfusion in fetuses with isolated CDH. Study Design This retrospective study evaluated fetuses with isolated, left‐sided CDH in three European referral centers. Abdominal circumference (AC), femur length (FL), head circumference (HC), transcerebellar diameter (TCD), middle cerebral artery (MCA) Doppler, and ventricular width (VW) were assessed during four gestational periods (<24 weeks, 25–28 weeks, 29–32 weeks, >33 weeks). Z‐scores were calculated, and growth curves were created based on longitudinal data. Results In 367 fetuses, HC, AC and FL were within normal ranges throughout gestation. The TCD diminished with advancing gestational age to fall below the fifth percentile after 32 weeks. A less pronounced but similar trend was seen in VW. The peak systolic velocity of the MCA was consistently approximately 10% lower than normal. Disease severity was correlated to TCD ( p = 0.002) and MCA doppler values ( p = 0.002). There were no differences between fetuses treated with FETO and those managed expectantly. Conclusion Fetuses with isolated left‐sided CDH have a small cerebellum and reduced MCA peak systolic velocity. Follow up studies are necessary to determine the impact of these changes on neurodevelopment.