Do Serial Sonographic Assessments of Fetuses with Isolated Congenital Diaphragmatic Hernia Help Us Predict Survival?

2021 ◽  
pp. 1-9
Author(s):  
Yael Furman ◽  
Ayelet Gavri-Beker ◽  
Tal Elkan Miller ◽  
Ron Bilik ◽  
Orgad Rosenblat ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Perinatal Death ◽  
Medical Center ◽  
Ecmo Support ◽  
Accurate Predictor ◽  
Tertiary Center ◽  
Twin Pregnancies ◽  
Perinatal Survival

<b><i>Objective:</i></b> The aim of this study was to assess the ability of serial prenatal sonographic measurements, and specifically changes in the observed-to-expected lung-to-head ratio (O/E LHR) throughout gestation and to predict survival in congenital diaphragmatic hernia (CDH). <b><i>Methods:</i></b> Retrospective study of CDH fetuses evaluated prenatally and treated postnatally in a single tertiary center, 2008–2020. Sonographic evaluations included side of herniation, liver involvement, and O/E LHR. All data were calculated to assess ability to predict survival. <b><i>Results:</i></b> Overall, 94 fetuses were evaluated prenatally and delivered in our medical center. Among them, 75 had isolated CDH and 19 nonisolated. CDH was categorized as left (<i>n</i> = 76; 80.8%), right (<i>n</i> = 16; 17.0%), or bilateral (<i>n</i> = 2; 2.2%). Overall perinatal survival rate was 57% for all live-born infants, 68% in isolated CDH, and 40% in nonisolated (excluding 2 cases that underwent fetoscopic endoluminal tracheal occlusion and did not survive). The O/E LHR was lower in cases with perinatal death compared to survivors. In cases with multiple evaluations, the minimal O/E LHR was the most accurate predictor of survival and need for perinatal extracorporeal membrane oxygenation (ECMO) support. This remained significant when excluding twin pregnancies or when evaluating only isolated left CDH. In addition to disease severity, the side of herniation and liver position was associated with preoperative mortality. <b><i>Conclusion:</i></b> O/E LHR is associated with perinatal survival. In cases with multiple evaluations, the minimal O/E LHR is the most accurate and significant predictor of perinatal mortality and need for ECMO support.

scholarly journals Fetoscopic tracheal occlusion for severe congenital diaphragmatic hernia: retrospective study

2017 ◽  
Vol 67 (4) ◽  
pp. 331-336
Author(s):  
Angélica de Fátima de Assunção Braga ◽  
Franklin Sarmento da Silva Braga ◽  
Solange Patricia Nascimento ◽  
Bruno Verri ◽  
Fabio C. Peralta ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Tracheal Occlusion

scholarly journals Neonates With Complex Cardiac Malformation and Congenital Diaphragmatic Hernia Born to SARS-CoV-2 Positive Women—A Single Center Experience

2020 ◽  
Vol 11 (6) ◽  
pp. 697-703
Author(s):  
Nimrod Goldshtrom ◽  
Diana Vargas ◽  
Angelica Vasquez ◽  
Faith Kim ◽  
Kinjal Desai ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Congenital Heart ◽  
Clinical Course ◽  
Medical Center ◽  
Horizontal Transmission ◽  
Academic Medical Center ◽  
Case Series ◽  
Adverse Outcomes ◽  
The Impact

Background: Our understanding of the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pregnancies and perinatal outcomes is limited. The clinical course of neonates born to women who acquired coronavirus disease 2019 (COVID-19) during their pregnancy has been previously described. However, the course of neonates born with complex congenital malformations during the COVID-19 pandemic is not known. Methods: We report a case series of seven neonates with congenital heart and lung malformations born to women who tested positive for SARS-CoV-2 during their pregnancy at a single academic medical center in New York City. Results: Six infants had congenital heart disease and one was diagnosed with congenital diaphragmatic hernia. In all seven infants, the clinical course was as expected for the congenital lesion. None of the seven exhibited symptoms generally associated with COVID-19. None of the infants in our case series tested positive by nasopharyngeal test for SARS-CoV-2 at 24 hours of life and at multiple points during their hospital course. Conclusions: In this case series, maternal infection with SARS-CoV-2 during pregnancy did not result in adverse outcomes in neonates with complex heart or lung malformations. Neither vertical nor horizontal transmission of SARS-CoV-2 was noted.

scholarly journals A maChine and deep Learning Approach to predict pulmoNary hyperteNsIon in newbornS with congenital diaphragmatic Hernia (CLANNISH): Protocol for a retrospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259724
Author(s):  
Ilaria Amodeo ◽  
Giorgio De Nunzio ◽  
Genny Raffaeli ◽  
Irene Borzani ◽  
Alice Griggio ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Pulmonary Hypertension ◽  
Deep Learning ◽  
Retrospective Study ◽  
Magnetic Resonance ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Lung Volume ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri

Introduction Outcome predictions of patients with congenital diaphragmatic hernia (CDH) still have some limitations in the prenatal estimate of postnatal pulmonary hypertension (PH). We propose applying Machine Learning (ML), and Deep Learning (DL) approaches to fetuses and newborns with CDH to develop forecasting models in prenatal epoch, based on the integrated analysis of clinical data, to provide neonatal PH as the first outcome and, possibly: favorable response to fetal endoscopic tracheal occlusion (FETO), need for Extracorporeal Membrane Oxygenation (ECMO), survival to ECMO, and death. Moreover, we plan to produce a (semi)automatic fetus lung segmentation system in Magnetic Resonance Imaging (MRI), which will be useful during project implementation but will also be an important tool itself to standardize lung volume measures for CDH fetuses. Methods and analytics Patients with isolated CDH from singleton pregnancies will be enrolled, whose prenatal checks were performed at the Fetal Surgery Unit of the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico (Milan, Italy) from the 30th week of gestation. A retrospective data collection of clinical and radiological variables from newborns’ and mothers’ clinical records will be performed for eligible patients born between 01/01/2012 and 31/12/2020. The native sequences from fetal magnetic resonance imaging (MRI) will be collected. Data from different sources will be integrated and analyzed using ML and DL, and forecasting algorithms will be developed for each outcome. Methods of data augmentation and dimensionality reduction (feature selection and extraction) will be employed to increase sample size and avoid overfitting. A software system for automatic fetal lung volume segmentation in MRI based on the DL 3D U-NET approach will also be developed. Ethics and dissemination This retrospective study received approval from the local ethics committee (Milan Area 2, Italy). The development of predictive models in CDH outcomes will provide a key contribution in disease prediction, early targeted interventions, and personalized management, with an overall improvement in care quality, resource allocation, healthcare, and family savings. Our findings will be validated in a future prospective multicenter cohort study. Registration The study was registered at ClinicalTrials.gov with the identifier NCT04609163.

scholarly journals Surfactant (SF) Treatment on Congenital Diaphragmatic Hernia (CDH). Retrospective Study

1999 ◽  
Vol 45 (4, Part 2 of 2) ◽  
pp. 324A-324A
Author(s):  
Adolf Valls-i-Soler ◽  
Maria Begona Fernandez-Ruanova ◽  
Bengt Robertson
Keyword(s):  
Retrospective Study ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia

Biological versus synthetic patch for the repair of congenital diaphragmatic hernia: 8-year experience at a tertiary center

2021 ◽  
Author(s):  
Gonzalez Rührnschopf Camila ◽  
Reusmann Aixa ◽  
Giuseppucci Carlos ◽  
Boglione Mariano ◽  
Arbio Soledad ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Tertiary Center
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