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Predictors of neonatal morbidity in fetuses with severe isolated congenital diaphragmatic hernia undergoing fetoscopic tracheal occlusion
Author(s) -
Doné E.,
Gratacos E.,
Nicolaides K. H.,
Allegaert K.,
Valencia C.,
Castañon M.,
Martinez J.M.,
Jani J.,
Van Mieghem T.,
Greenough A.,
Gomez O.,
Lewi P.,
Deprest J.
Publication year - 2013
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.12445
Subject(s) - medicine , congenital diaphragmatic hernia , pulmonary hypoplasia , gestational age , mechanical ventilation , fetoscopy , diaphragmatic hernia , gestation , hypoplasia , surgery , obstetrics , fetus , prenatal diagnosis , hernia , pregnancy , anesthesia , genetics , biology
Objectives To investigate neonatal morbidity in fetuses with severe congenital diaphragmatic hernia ( CDH ) treated with fetoscopic endoluminal tracheal occlusion ( FETO ) and compare it with historical controls with less severe forms of CDH that were managed expectantly . Methods This was a prospective, multicenter study on neonatal outcomes and prenatal predictors in 90 FETO survivors (78 left‐sided, 12 right) and 41 controls from the antenatal CDH registry with either severe or moderate hypoplasia who were managed expectantly. We also investigated early neonatal morbidity indicators, including the need for patch repair, duration of mechanical ventilation and supplemental oxygen, age at full enteral feeding and incidence of pulmonary hypertension . Results Gestational age at delivery was predictive of duration of assisted ventilation ( P = 0.046), days on supplemental oxygen ( P = 0.019) and age at full enteral feeding ( P = 0.020). When delivery took place after 34 weeks' gestation, neonatal morbidity of FETO cases was comparable with that of expectantly managed cases with moderate hypoplasia . Conclusions Fetal intervention for severe CDH is associated with neonatal morbidity that is comparable with that of an expectantly managed group with less severe disease. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd .