Predicting Neonatal Deaths and Pulmonary Hypoplasia in Isolated Congenital Diaphragmatic Hernia Using the Sonographic Fetal Lung Volume–Body Weight Ratio

2008 ◽  
Vol 190 (5) ◽  
pp. 1216-1219 ◽  
Author(s):  
Rodrigo Ruano ◽  
Marie-Cecile Aubry ◽  
Yves Dumez ◽  
Marcelo Zugaib ◽  
Alexandra Benachi
Keyword(s):  
Body Weight ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Lung Volume ◽  
Pulmonary Hypoplasia ◽  
Weight Ratio ◽  
Fetal Lung ◽  
Body Weight Ratio ◽  
Neonatal Deaths

Lung Pathology in Patients with Congenital Diaphragmatic Hernia Treated with Fetal Surgical Intervention, Including Tracheal Occlusion

2003 ◽  
Vol 6 (6) ◽  
pp. 536-546 ◽  
Author(s):  
Amy E. Heerema ◽  
Joseph T. Rabban ◽  
Roman M. Sydorak ◽  
Micheal R. Harrison ◽  
Kirk D. Jones
Keyword(s):  
Body Weight ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Pulmonary Hypoplasia ◽  
Weight Ratio ◽  
Lung Pathology ◽  
Body Weight Ratio ◽  
Fetal Intervention ◽  
Tracheal Occlusion ◽  
Significant Difference

Fetal intervention for congenital diaphragmatic hernia was developed to lessen the high morbidity and mortality of pulmonary hypoplasia. Lung pathology and morphometry in patients treated with fetal intervention have not been described. We report clinical and autopsy findings, as well as basic lung morphometry in 16 cases of congenital diaphragmatic hernia with fetal intervention (12 cases tracheal occlusion; 4 cases hernia repair), and 19 cases of congenital diaphragmatic hernia without fetal intervention. All patients who underwent fetal intervention were born premature. Lung enlargement with increased lung-to-body weight ratio was observed with fetal tracheal occlusion, accompanied by lower than normal radial alveolar counts and increased alveolar size. Patients treated with tracheal occlusion also had early alveolar development (at 29.8, 30.6, and 30.9 wk postconceptual age) as well as mucous fluid pooling in airways and alveoli. All cases showed severe alveolar septal widening, more extensive in patients without fetal intervention. When grouped by postconceptual age, no statistically significant difference was found between patients with and without fetal intervention with respect to lung-to-body weight ratio, radial alveolar count, mean alveolar length, and relative arteriolar media thickness. Lung enlargement has been observed with fetal tracheal occlusion sonographically; our studies suggest that this is due in part to emphysema and mucous fluid pooling. The lung remains abnormal with low radial alveolar counts and increased alveolar size. Tracheal occlusion did not prevent development of lung pathology associated with pulmonary hypoplasia.

scholarly journals Predicting pulmonary hypoplasia using the sonographic fetal lung volume to body weight ratio - how precise and accurate is it?

2006 ◽  
Vol 28 (7) ◽  
pp. 958-962 ◽  
Author(s):  
R. Ruano ◽  
J. Martinovic ◽  
M. -C. Aubry ◽  
Y. Dumez ◽  
A. Benachi
Keyword(s):  
Body Weight ◽  
Lung Volume ◽  
Pulmonary Hypoplasia ◽  
Weight Ratio ◽  
Fetal Lung ◽  
Body Weight Ratio

413: Duration of tracheal occlusion predicts lung-body-weight ratio in a nitrofen rat model of congenital diaphragmatic hernia

2011 ◽  
Vol 204 (1) ◽  
pp. S167
Author(s):  
Veronika Beck ◽  
Sebastiaan Deckx ◽  
Inga Sandaite ◽  
Paul Lewi ◽  
Steffi Mayer ◽  
...  
Keyword(s):  
Body Weight ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Rat Model ◽  
Weight Ratio ◽  
Body Weight Ratio ◽  
Tracheal Occlusion

scholarly journals Amniotic fluid stem cell extracellular vesicles promote fetal lung branching and cell differentiation in experimental congenital diaphragmatic hernia

2022 ◽  
Author(s):  
Kasra Khalaj ◽  
Rebeca Lopes Figueira ◽  
Lina Antounians ◽  
Sree Gandhi ◽  
Matthew Wales ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Congenital Diaphragmatic Hernia ◽  
Extracellular Vesicles ◽  
Diaphragmatic Hernia ◽  
Lung Development ◽  
Pulmonary Hypoplasia ◽  
Fetal Lung ◽  
Branching Morphogenesis ◽  
Neuroendocrine Cells ◽  
Beta Catenin

Pulmonary hypoplasia secondary to congenital diaphragmatic hernia (CDH) is characterized by impaired branching morphogenesis and differentiation. We have previously demonstrated that administration of extracellular vesicles derived from rat amniotic fluid stem cells (AFSC-EVs) rescues development of hypoplastic lungs at the pseudoglandular and alveolar stages in rodent models of CDH. Herein, we tested whether AFSC-EVs exert their regenerative effects at the canalicular and saccular stages, as these are translationally relevant for clinical intervention. To induce fetal pulmonary hypoplasia, we gavaged rat dams with nitrofen at embryonic day 9.5 and demonstrated that nitrofen-exposed lungs had impaired branching morphogenesis, dysregulated signaling pathways relevant to lung development (FGF10/FGFR2, ROBO/SLIT, Ephrin, Neuropilin 1, beta-catenin) and impaired epithelial and mesenchymal cell marker expression at both stages. AFSC-EVs administered to nitrofen-exposed lung explants rescued airspace density and increased the expression levels of key factors responsible for branching morphogenesis. Moreover, AFSC-EVs rescued the expression of alveolar type 1 and 2 cell markers at both canalicular and saccular stages, and restored markers of club, ciliated epithelial, and pulmonary neuroendocrine cells at the saccular stage. AFSC-EV treated lungs also had restored markers of lipofibroblasts and PDGFRA+ cells to control levels at both stages. EV tracking showed uptake of AFSC-EV RNA cargo throughout the fetal lung and an mRNA-miRNA network analysis identified that several miRNAs responsible for regulating lung development processes were contained in the AFSC-EV cargo. These findings suggest that AFSC-EV based therapies hold potential for restoring fetal lung growth and maturation in babies with pulmonary hypoplasia secondary to CDH.

scholarly journals P09.11: What is the precision of 3DUS in estimating fetal lung volume in congenital diaphragmatic hernia?

2004 ◽  
Vol 24 (3) ◽  
pp. 319-320
Author(s):  
R. Ruano ◽  
J. Martinovic ◽  
A. Benachi ◽  
L. Joubin ◽  
M. C. Aubry ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Lung Volume ◽  
Fetal Lung

Pulmonary Hypoplasia: Prediction with Use of Ratio of MR Imaging–measured Fetal Lung Volume to US-estimated Fetal Body Weight

Radiology ◽  
2004 ◽  
Vol 232 (3) ◽  
pp. 767-772 ◽  
Author(s):  
Shinji Tanigaki ◽  
Kei Miyakoshi ◽  
Mamoru Tanaka ◽  
Yoshihisa Hattori ◽  
Tadashi Matsumoto ◽  
...  
Keyword(s):  
Body Weight ◽  
Mr Imaging ◽  
Lung Volume ◽  
Pulmonary Hypoplasia ◽  
Fetal Lung

scholarly journals Prevention of pulmonary hypoplasia and pulmonary vascular remodeling by antenatal simvastatin treatment in nitrofen-induced congenital diaphragmatic hernia

2015 ◽  
Vol 308 (7) ◽  
pp. L672-L682 ◽  
Author(s):  
Martine Makanga ◽  
Hidekazu Maruyama ◽  
Celine Dewachter ◽  
Agnès Mendes Da Costa ◽  
Emeline Hupkens ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Body Weight ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Weight Ratio ◽  
The Body ◽  
Lung Hypoplasia ◽  
External Diameter ◽  
Pathological Features ◽  
Pulmonary Vessel

Congenital diaphragmatic hernia (CDH) has a high mortality rate mainly due to lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Simvastatin has been shown to prevent the development of pulmonary hypertension (PH) in experimental models of PH. We, therefore, hypothesized that antenatal simvastatin would attenuate PPHN in nitrofen-induced CDH in rats. The efficacy of antenatal simvastatin was compared with antenatal sildenafil, which has already been shown to improve pathological features of PPHN in nitrofen-induced CDH. On embryonic day (E) 9.5, nitrofen or vehicle was administered to pregnant Sprague-Dawley rats. On E11, nitrofen-treated rats were randomly assigned to antenatal simvastatin (20 mg·kg−1·day−1 orally), antenatal sildenafil (100 mg·kg−1·day−1 orally), or placebo administration from E11 to E21. On E21, fetuses were delivered by cesarean section, killed, and checked for left-sided CDH. Lung tissue was then harvested for further pathobiological evaluation. In nitrofen-induced CDH, simvastatin failed to reduce the incidence of nitrofen-induced CDH in the offspring and to increase the body weight, but improved the lung-to-body weight ratio and lung parenchyma structure. Antenatal simvastatin restored the pulmonary vessel density and external diameter, and reduced the pulmonary arteriolar remodeling compared with nitrofen-induced CDH. This was associated with decreased lung expression of endothelin precursor, endothelin type A and B receptors, endothelial and inducible nitric oxide synthase, together with restored lung activation of apoptotic processes mainly in the epithelium. Antenatal simvastatin presented similar effects as antenatal therapy with sildenafil on nitrofen-induced CDH. Antenatal simvastatin improves pathological features of lung hypoplasia and PPHN in experimental nitrofen-induced CDH.

MR Relative Fetal Lung Volume in Congenital Diaphragmatic Hernia: Survival and Need for Extracorporeal Membrane Oxygenation

Radiology ◽  
2008 ◽  
Vol 248 (1) ◽  
pp. 240-246 ◽  
Author(s):  
Karen A. Büsing ◽  
A. Kristina Kilian ◽  
Thomas Schaible ◽  
Claudia Endler ◽  
Regine Schaffelder ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Lung Volume ◽  
Fetal Lung ◽  
Membrane Oxygenation
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