Predicting perinatal outcome in isolated congenital diaphragmatic hernia using fetal pulmonary artery diameters.
OBJECTIVE
The aim of the study was to evaluate the potential of fetal pulmonary artery (PA) diameters to predict perinatal death and pulmonary arterial hypertension (PAH) in congenital diaphragmatic hernia (CDH).


METHODS
In this prospective observational study, observed PA (main, right, and left) diameters were measured at the level of the 3 vessels in 21 fetuses with isolated CDH and in 85 controls at 22 to 36 weeks. The observed/expected (o/e) diameters of the main, contralateral, and ipsilateral PAs were calculated by comparing these measurements with reference values obtained in our previous study and correlated with perinatal death and postnatal PAH.


RESULTS
The o/e PA diameters were significantly reduced in fetuses with CDH compared to controls (P < .001) and in fetuses with CDH who died (P < .050). However, there was no significant association between PA diameters and PAH (P >or= .050).


CONCLUSIONS
The PA diameters might be useful to predict perinatal death in isolated CDH but not postnatal PAH, suggesting that PA diameters are probably related to the severity of pulmonary hypoplasia.
Ruano
Rodrigo
R
Université Paris-Descartes, Faculté de Médecine, AP-HP, Maternité, Hôpital Necker-Enfants Malades, 75743 cedex 15, Paris, France. rodrigoruano@hotmail.com
Aubry
Marie-Cécile
MC
Barthe
Bruno
B
Mitanchez
Delphine
D
Dumez
Yves
Y
Benachi
Alexandra
A
D006548:Hernia, Diaphragmatic / Q000150:complications / Q000175:diagnosis*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000196:embryology*; D016216:Ultrasonography, Prenatal; D014894:Weights and Measures