title: Cardiac fetal ultrasonographic parameters for predicting outcomes of isolated left-sided congenital diaphragmatic hernia.
abstract: BACKGROUND
  The purpose of this study was to investigate fetal cardiac ultrasonographic parameters in relation to the outcomes of patients with isolated left-sided congenital diaphragmatic hernia (CDH).
  
  
  METHODS
  Subjects comprised 33 fetuses with fetal CDH and 99 control fetuses without cardiac and lung anomalies. Three parameters, cardiothoracic area ratio (CTAR), the ratio of the diameter of the main pulmonary artery to that of the ascending aorta (MPA/AAo), and the ratio of the diameter of the tricuspid valve to that of the mitral valve (TV/MV) were compared between fetal CDH and control subjects and between survival (SG) and non-survival (NSG) groups.
  
  
  RESULTS
  All three parameters differed significantly between CDH and control fetuses. Significant differences between SG and NSG were observed in CTAR and TV/MV ratio, but not in MPA/AAo ratio before and after 32 gestational weeks. A significant increase in the TV/MV ratio was noted along with an increase in gestational age. A TV/MV ratio of >1.72 discriminated non-survivors from survivors with better sensitivity and specificity.
  
  
  CONCLUSIONS
  Fetal cardiac ultrasonography provides useful information for predicting the outcomes of isolated left-sided CDH. The TV/MV ratio was considered a reliable indicator that reflected outcomes of isolated left-sided CDH.
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan. Electronic address: smashace1018@yahoo.co.jp.
authors.forename: Masaya
authors.initials: M
authors.lastname: Yamoto
authors.affiliation: Department of Cardiology, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Fukumoto
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nakajima
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Koyama
authors.affiliation: Department of Cardiology, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Norie
authors.initials: N
authors.lastname: Mitsushita
authors.affiliation: Department of Cardiology, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Nii
authors.affiliation: Department of Pediatric Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Kawahara
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Urushihara
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D005865:Gestational Age; D065630:Hernias, Diaphragmatic, Congenital / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D008297:Male; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal
keywords: Cardiothoracic area ratio; Congenital diaphragmatic hernia; Fetal cardiac ultrasonography; Main pulmonary artery to ascending aorta diameter ratio; Tricuspid valve to mitral valve diameter ratio