title: Predictors of neonatal morbidity in fetuses with severe isolated congenital diaphragmatic hernia undergoing fetoscopic tracheal occlusion.
abstract: OBJECTIVE
  To investigate neonatal morbidity in fetuses with severe congenital diaphragmatic hernia (CDH) treated with fetoscopic endoluminal tracheal occlusion (FETO) and compare it with historical controls with less severe forms of CDH that were managed expectantly.
  
  
  METHODS
  This was a prospective, multicenter study on neonatal outcomes and prenatal predictors in 90 FETO survivors (78 left-sided, 12 right) and 41 controls from the antenatal CDH registry with either severe or moderate hypoplasia who were managed expectantly. We also investigated early neonatal morbidity indicators, including the need for patch repair, duration of mechanical ventilation and supplemental oxygen, age at full enteral feeding and incidence of pulmonary hypertension.
  
  
  RESULTS
  Gestational age at delivery was predictive of duration of assisted ventilation (P = 0.046), days on supplemental oxygen (P = 0.019) and age at full enteral feeding (P = 0.020). When delivery took place after 34 weeks' gestation, neonatal morbidity of FETO cases was comparable with that of expectantly managed cases with moderate hypoplasia.
  
  
  CONCLUSIONS
  Fetal intervention for severe CDH is associated with neonatal morbidity that is comparable with that of an expectantly managed group with less severe disease.
authors: Department of Obstetrics and Gynaecology, Division of Woman and Child, University Hospitals Leuven, Leuven, Belgium.
authors: E
authors: E
authors: Doné
authors: E
authors: E
authors: Gratacos
authors: K H
authors: KH
authors: Nicolaides
authors: K
authors: K
authors: Allegaert
authors: C
authors: C
authors: Valencia
authors: M
authors: M
authors: Castañon
authors: J-M
authors: JM
authors: Martinez
authors: J
authors: J
authors: Jani
authors: T
authors: T
authors: Van Mieghem
authors: A
authors: A
authors: Greenough
authors: O
authors: O
authors: Gomez
authors: P
authors: P
authors: Lewi
authors: J
authors: J
authors: Deprest
mesh_terms: D000704:Analysis of Variance; D021721:Balloon Occlusion / Q000009:adverse effects; D001530:Belgium / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D005260:Female; D005332:Fetoscopy / Q000009:adverse effects; D005865:Gestational Age; D006548:Hernia, Diaphragmatic / Q000196:embryology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods* / Q000706:statistics & numerical data; D013030:Spain / Q000453:epidemiology; D014132:Trachea; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal