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Title: Outcome of fetuses with congenital diaphragmatic hernia and associated intra-fetal fluid effusions managed in the era of fetal surgery
Authors: Van Mieghem, Tim ×
Martinez, Rogelio Cruz
Allegaert, Karel
DeKoninck, Philip
Castanon, Montserrat
Sandaite, Inga
Claus, Filip
Devlieger, Roland
Gratacos, Eduard
Deprest, Jan #
Issue Date: Jan-2012
Publisher: Blackwell Science
Series Title: Ultrasound in Obstetrics & Gynecology vol:39 issue:1 pages:50-55
Article number: 10.1002/uog.10097
Abstract: OBJECTIVE: Fetuses with congenital diaphragmatic hernia (CDH) and additional abnormal ultrasound findings are typically considered to have a dismal prognosis. Our aim was to assess the outcome of fetuses with CDH and associated intra-fetal fluid effusions. METHODS: Retrospective bicentric cohort study on the perinatal management of fetuses with CDH and intra-fetal fluid effusions. RESULTS: The incidence of effusions was 5.2% (n = 14) in 269 consecutive cases of left sided CDH and 29.2% (n = 14) in 48 cases of right sided CDH. Hydrothorax (n = 19; 68%) and ascites (n = 16; 57%) were the most common effusions. A combination of both was present in 11 (38%) fetuses. Of 20 ongoing pregnancies with CDH and fluid effusions, yet no other anomalies, 5 with moderate or mild pulmonary hypoplasia were managed without fetoscopic endoluminal tracheal occlusion (FETO). The 15 other cases underwent FETO because of severe pulmonary hypoplasia. Neonatal survival was similar in both groups (n = 2/5 and n = 6/15 respectively; p = 1.0). Survival in the cases that underwent FETO was similar to previously published results in isolated cases undergoing FETO. CONCLUSIONS: Our observations do not support the view that intra-fetal effusions are an adverse prognostic factor in fetuses with CDH. In CDH fetuses with effusions and severe pulmonary hypoplasia treated by FETO, neonatal survival is similar as in isolated cases undergoing the intervention. Whether pleural effusions should be addressed by thoracic drainage procedures remains unproven. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
ISSN: 0960-7692
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Organ Systems (+)
Foetal Medicine Section (-)
Section Newborn (-)
Section Woman - Miscellaneous (-)
Radiology
Pathophysiology of Pregnancy Section (-)
× corresponding author
# (joint) last author

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