Decreased morbidity of ‘bowel‐only’ left congenital diaphragmatic hernia patients: implications of prenatal ultrasound diagnosis for prenatal counseling and postnatal management

2021 ◽  
Author(s):  
R. A. Didier ◽  
E. R. Oliver ◽  
P. Rungsiprakarn ◽  
S. E. DeBari ◽  
S. E. Adams ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Prenatal Ultrasound ◽  
Ultrasound Diagnosis ◽  
Prenatal Counseling ◽  
Postnatal Management

The case of prenatal ultrasound diagnosis of fibular hemimelia, type I associated with oligodactyly of the foot in the second trimester of gestation

2020 ◽  
Author(s):  
I.N. Daminov
Keyword(s):  
Ultrasound Examination ◽  
Lower Extremities ◽  
Lower Leg ◽  
Prenatal Ultrasound ◽  
Ultrasound Diagnosis ◽  
Type I ◽  
Second Trimester ◽  
Prenatal Counseling ◽  
External Examination ◽  
Fibular Hemimelia

A case of prenatal ultrasound diagnosis of fibular hemimelia, type I associated with oligodactyly of the foot at 22 weeks of gestation is presented. Ultrasound examination at 22 weeks of gestation revealed hypoplasia of the left fibula and the foot oligodactyly. After prenatal counseling, the patient opted for termination of pregnancy. During external examination of the abortus asymmetry of the lower extremities due to shortening of the left lower leg and oligodactyly of the left foot were noted, those confirmed prenatal ultrasound data.

Possibility of application of prenatal ultrasound indexes in congenital diaphragmatic hernia in fetus to determine postnatal outcomes

2021 ◽  
Author(s):  
N.V. Mashinets
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Pleural Cavity ◽  
Prenatal Ultrasound ◽  
Lung Hypoplasia ◽  
Prenatal Period ◽  
Compression Index ◽  
Disease Group ◽  
Group I ◽  
Group Ii

Objectives. To assess the effectiveness of the use of prenatal ultrasound indexes in congenital diaphragmatic hernia of the fetus to determine the postnatal prognosis. Materials. The analysis of 95 observations of left-sided congenital diaphragmatic hernia of the fetus was carried out. In the prenatal period, the composition of organs displaced into the pleural cavity was determined, the heart compression index (HCI), O/E LHR according to Jani and DeKoninck, and QLI were calculated. Results. Survival rate of newborns was 57.9%, mortality rate was 42.1%. The newborns were divided into two groups depending on the outcome of the disease. Group I — surviving newborns (n = 55), group II — deceased patients (n = 40). In the analyzed groups, there were no statistical differences in the timing of delivery, birth weight of newborns, the severity of asphyxia after birth and the type of hernia. In group I, the intestinal loops and stomach were significantly more often identified in the pleural cavity in isolation, less often the liver. HCI corresponded to 1.3, Jani O/E LHR 45.7%, DeKoninck O/E LHR 38.7%, QLI 0.7. In group II, concomitant malformations, polyhydramnios and displacement of the liver into the pleural cavity were significantly more frequent. HCI was 1.5, Jani O/E LHR 38.6%, DeKoninck O/E LHR 32.0%, QLI 0.6. Conclusions. In predicting the outcome of the disease for a newborn, the most effective is a comprehensive assessment of the location of the liver, the heart compression index and the index of lung hypoplasia (O/E LHR according to Jani). The diagnostic accuracy of the method is 80%, the sensitivity is 74.4%, and the specificity is 83.3%.

Postnatal Management of Congenital Diaphragmatic Hernia

1996 ◽  
Vol 23 (4) ◽  
pp. 843-872 ◽  
Author(s):  
Desmond J. Bohn ◽  
Richard Pearl ◽  
Michael S. Irish ◽  
Philip L. Glick
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Postnatal Management

Novel Risk Score for Fetuses with Congenital Diaphragmatic Hernia Based on Ultrasound Findings

2019 ◽  
Vol 30 (01) ◽  
pp. 051-058
Author(s):  
Keita Terui ◽  
Kouji Nagata ◽  
Masahiro Hayakawa ◽  
Hiroomi Okuyama ◽  
Shoichirou Amari ◽  
...  
Keyword(s):  
Prediction Model ◽  
Congenital Diaphragmatic Hernia ◽  
Risk Score ◽  
Diaphragmatic Hernia ◽  
Validation Cohort ◽  
Prenatal Ultrasound ◽  
Odds Ratios ◽  
Ultrasound Findings ◽  
Liver Herniation ◽  
Thoracic Stomach

Abstract Introduction We aimed to establish and validate a risk score for fetuses with congenital diaphragmatic hernia (CDH) using only prenatal ultrasound findings. Material and Methods Derivation (2011–2016, n = 350) and validation (2006–2010, n = 270) cohorts were obtained from a Japanese CDH study group database. Using a logistic regression analysis, we created a prediction model and weighted scoring system from the derivation dataset and calculated the odds ratio of an unsatisfactory prognosis (death within 90 days of life or hospitalization duration exceeding 180 days). Five adverse prognostic factors obtained using prenatal ultrasound, including an observed/expected lung area-to-head circumference ratio (o/eLHR) <25%, liver herniation occupying more than one-third of the thoracic space, thoracic stomach, right-side CDH, and severe malformations, were used as predictors. The obtained model was validated using the validation cohort. Results The unsatisfactory prognosis prediction model was obtained based on the adjusted odds ratios. The C statistics of the model were 0.83 and 0.80 in the derivation and validation datasets, respectively. The five variables were weighted proportionally to their adjusted odds ratios for an unsatisfactory prognosis (o/eLHR <25%, 1 point; liver herniation occupying more than one-third of the thoracic space, 1 point; thoracic stomach, 1 point; right-side CDH, 2 points; and severe malformations, 3 points). Unsatisfactory prognosis rates for the low- (0–2 points), intermediate- (3–5 points), and high-risk (6–8 points) groups were 17, 46, and 100%, respectively (p < 0.001), in the validation cohort. Conclusion Our simple risk score effectively predicted the prognosis of fetuses with CDH.

Sensorineural hearing loss in congenital diaphragmatic hernia survivors is associated with postnatal management and not defect size

2014 ◽  
Vol 49 (6) ◽  
pp. 895-899 ◽  
Author(s):  
Kate V. Dennett ◽  
Brian J. Fligor ◽  
Sarah Tracy ◽  
Jay M. Wilson ◽  
David Zurakowski ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Congenital Diaphragmatic Hernia ◽  
Sensorineural Hearing Loss ◽  
Diaphragmatic Hernia ◽  
Defect Size ◽  
Sensorineural Hearing ◽  
Postnatal Management
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