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Prenatal stomach position and volume in relation to postnatal outcomes in left‐sided congenital diaphragmatic hernia
Author(s) -
Weller Katinka,
Peters Nina C. J.,
Rosmalen Joost,
CochiusDen Otter Suzan C. M.,
DeKoninck Philip L. J.,
Wijnen Rene M. H.,
CohenOverbeek Titia E.,
Eggink Alex J.
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.6019
Subject(s) - congenital diaphragmatic hernia , medicine , fetus , gestational age , prenatal diagnosis , diaphragmatic hernia , stomach , gastroenterology , pulmonary hypoplasia , gestation , obstetrics , pregnancy , diaphragmatic breathing , respiratory system , hernia , pediatrics , surgery , pathology , biology , genetics , alternative medicine
Objective To examine the association between prenatal stomach position (SP) grade and stomach volume (SV) and the need for pulmonary hypertension (PH) treatment after birth in prenatally diagnosed left‐sided congenital diaphragmatic hernia (CDH), live born >34 weeks. Methods In retrospect, SP grade and SV were determined in fetuses with isolated left‐sided CDH from 19 weeks gestational age (GA) onwards at three different time periods (≤24 weeks' GA: US1, 24–30 weeks' GA: US2; ≥30 weeks' GA: US3). Primary outcome was need for treatment of PH after birth. Secondary analyses included the predictive value of SP and SV for other respiratory outcomes and postnatal defect size. Results A total of 101 fetuses were included. SP grade was significantly associated with need for treatment of PH (US1, US2, and US3: p < 0.02). Also, prenatal SP grade was positively associated with defect size and development of chronic lung disease (CLD) in survivors. No association was found between SV and respiratory morbidities or postnatal defect size. Conclusion SP grade in left‐sided CDH fetuses is associated with an increased need for PH treatment, a larger postnatal defect size and CLD in survivors. We consider SP determination a valuable contribution to the prenatal assessment of left‐sided CDH.