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Image-based prenatal predictors of postnatal survival, extracorporeal life support, and defect size in right congenital diaphragmatic hernia

Journal of Perinatology volume 42, pages 1202–1209 (2022)Cite this article

Subjects

Abstract

Objective

To determine the association between prenatal ultrasound (US) and magnetic resonance imaging (MRI) characteristics in right congenital diaphragmatic hernia (RCDH) with postnatal outcome.

Study design

CDH Study Group data were reviewed for all RCDH infants (n = 156) born between 2015 and 2019. Prenatal US and MRI lung size measurements were correlated with survival, extracorporeal life support (ECLS), and defect size.

Result

Overall survival was 64.1%. ECLS was required in 40.4%. US and MRI-based prenatal assessment of pulmonary hypoplasia does not predict survival. Prenatal measurement of lung size using either US or MRI correlates with ECLS use. Only MRI-based measures of lung size are associated with defect size.

Conclusion

Image-based prenatal predictors of survival, ECLS, and defect size are of limited value in RCDH. Extrapolation of prenatal survival and morbidity indicators from left to right-sided CDH is not appropriate. There is an urgent need to develop RCDH prenatal prediction models.

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Fig. 1
Fig. 2: Relationship of lung imaging measures with survival and ECLS use.
Fig. 3

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Data availability

The data that supports the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors have no conflicts of interest to disclose. This information has not been presented, is not published elsewhere, and is not under any simultaneous consideration.

Author information

Authors and Affiliations

  1. Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, 94305, USA

    Enrico Danzer, Valerie Y. Chock, Caroline Y. Noh, Krisa P. van Meurs & Krisa P. van Meurs

  2. Department of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, 94304, USA

    Sukyung Chung

  3. University of Texas Health Science Center at Houston, Children’s Memorial Hermann Hospital, Department of Pediatric Surgery, Houston, TX, 77030, USA

    Pamela A. Lally, Matthew T. Harting, Kevin P. Lally & Ashley H. Ebanks

  4. University of Michigan, C.S. Mott Children’s Hospital, Department of Pediatric Surgery, Ann Arbor, MI, 48109, USA

    Erin E. Perrone

Authors
  1. Enrico Danzer
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  2. Valerie Y. Chock
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Consortia

The Congenital Diaphragmatic Hernia Study Group

  • Enrico Danzer
  • , Valerie Y. Chock
  • , Sukyung Chung
  • , Caroline Y. Noh
  • , Pamela A. Lally
  • , Matthew T. Harting
  • , Kevin P. Lally
  • , Erin E. Perrone
  • , Ashley H. Ebanks
  •  & Krisa P. van Meurs

Contributions

Study conception and design: ED, MTH, KPL, EEP, KPVM; Data acquisition: PAL, AHE; Analysis and data interpretation: ED, SC, VYC, CYN, KPVM; Drafting of the manuscript: ED, VYC, SC, KPVM; Critical revision: ED, VYC, SC, CYN, PAL, MTH, KPL, EEP, AHE, KPVM.

Corresponding author

Correspondence to Enrico Danzer.

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Danzer, E., Chock, V.Y., Chung, S. et al. Image-based prenatal predictors of postnatal survival, extracorporeal life support, and defect size in right congenital diaphragmatic hernia. J Perinatol 42, 1202–1209 (2022). https://doi.org/10.1038/s41372-022-01470-x

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