title: Patterns of fetal lung growth in fetuses with isolated left-sided congenital diaphragmatic hernia.
abstract: OBJECTIVE
  To evaluate right lung growth pattern in fetuses with isolated left-sided congenital diaphragmatic hernia (iL-CDH) and to analyze the pattern according to postnatal outcome.
  
  
  METHODS
  Lung-to-head ratio (LHR) and observed-to-expected LHR (O/E LHR) were obtained in 58 cases. Correlation and regression analysis for the total number of measurements, general linear models for those cases with a least three serial measurements and linear mixed effect models were used to analyze the influence of gestational age on the right lung size. Cases expectantly managed and those with fetal endoscopic tracheal occlusion were analyzed separately.
  
  
  RESULTS
  LHR, but not O/E LHR, increased significantly with gestational age (GA) (r = 0.43, p = 0.003 and r = -0.13, p = 0.30, respectively). According to neonatal mortality, in those fetuses that died, LHR remained unchanged and O/E LHR decreased significantly with GA (r = 0.07, p = 0.65 and r = -0.37, p = 0.02, respectively). In those cases with at least three serial measurements, the same two patterns were found. Similarly, in cases with expectant management, surviving fetuses showed a significantly higher weekly increase in LHR (p = 0.01) and a trend to a lower weekly decrease in O/E LHR (p = 0.17) than in those that died.
  
  
  CONCLUSIONS
  Patterns of right lung growth in iL-CDH differ according to postnatal survival. Serial measurements, but not a single one, might increase the prediction of neonatal death.
authors.affiliation: a Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology , Hospital Universitario La Paz , Madrid , Spain .
authors.forename: Eugenia
authors.initials: E
authors.lastname: Antolin
authors.affiliation: a Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology , Hospital Universitario La Paz , Madrid , Spain .
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodriguez
authors.affiliation: b Department of Pediatric Surgery , Hospital Universitario La Paz , Madrid , Spain , and.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Encinas
authors.affiliation: a Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology , Hospital Universitario La Paz , Madrid , Spain .
authors.forename: Beatriz
authors.initials: B
authors.lastname: Herrero
authors.affiliation: a Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology , Hospital Universitario La Paz , Madrid , Spain .
authors.forename: Marta
authors.initials: M
authors.lastname: Muner
authors.affiliation: c Fetal Medicine Unit, Department of Obstetrics and Gynecology , Hospital Universitario Gregorio Marañon , Madrid , Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Perez
authors.affiliation: c Fetal Medicine Unit, Department of Obstetrics and Gynecology , Hospital Universitario Gregorio Marañon , Madrid , Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Ortiz
authors.affiliation: a Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology , Hospital Universitario La Paz , Madrid , Spain .
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Bartha
mesh_terms: D000328:Adult; D005260:Female; D047109:Fetal Development; D005333:Fetus; D065630:Hernias, Diaphragmatic, Congenital / Q000000981:diagnostic imaging / Q000196:embryology*; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008168:Lung / Q000000981:diagnostic imaging / Q000196:embryology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D012044:Regression Analysis; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: Congenital diaphragmatic hernia; fetal lung growth; prenatal prognosis; pulmonary hypertension; pulmonary hypoplasia