Fetal preload index of the inferior vena cava and neonatal outcome of congenital diaphragmatic hernia.
OBJECTIVE
The purpose of this study was to assess prognostic factors in patients with congenital diaphragmatic hernia (CDH).


METHODS
Thirteen patients with CDH diagnosed antenatally and delivered in our hospital between 1995 and 2006 were retrospectively studied. Assessments of sonographic examinations included gestational age at time of diagnosis; the ultrasonographic parameters [amniotic fluid index, cardiothoracic area ratio, and the lung-thoracic transverse area ratio (LTR)]; and the incidence of polyhydramnios, intrauterine growth retardation, and hydrops. Doppler velocimetry measurements comprised the resistance index of the umbilical artery, the resistance index of the midcerebral artery, the maximal velocity of the descending aorta, and the preload index of the inferior vena cava (IVCPLI). Results were expressed as the mean ± standard deviation. The features of survivors and nonsurvivors were compared.


RESULTS
Six fetuses were survivors and seven were nonsurvivors. The mean LTR value tended to be markedly low in both groups (23.8 ± 16.4 vs 12.1 ± 1.1). In Doppler analysis, the mean IVCPLI value in survivors was significantly lower than that in nonsurvivors (0.34 ± 0.08 vs 0.52 ± 0.14, P = 0.01).


CONCLUSIONS
We concluded that fetal IVCPLI might be a good predictor of the outcome in patients with CDH.
Department of Obstetrics and Gynecology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Hiroshi
H
Miura
Department of Obstetrics and Gynecology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. ogawapen@gipc.akita-u.ac.jp.
Masaki
M
Ogawa
Department of Obstetrics and Gynecology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Akira
A
Sato
Department of Obstetrics and Gynecology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Jun
J
Fukuda
Department of Obstetrics and Gynecology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Toshinobu
T
Tanaka
Doppler velocimetry; congenital diaphragmatic hernia; inferior vena cava; preload index; prenatal diagnosis