OBSTETRICS AND GYNAECOLOGY / RESEARCH PAPER
Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia.
| 1 | Department of Obstetrics and Gynaecology, Polish Mother's Memorial Hospital Research Institute, Poland |
| 2 | Department for Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Poland |
| 3 | Department of Obstetrics, Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, Poland |
| 4 | Faculty of Health Sciences, State University of Applied Sciences in Plock, Poland |
| 5 | Department of Neonatology, Polish Mother’s Memorial Hospital Research Institute, Poland |
| 6 | Department of Intensive Care and Congenital Malformations of Newborns and Infants, Polish Mother's Memorial Hospital Research Institute, Poland |
| 7 | Department for Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland, Poland |
| 8 | Department of Diagnosis and Prevention of Fetal Malformations, Medical University of Lodz, Lodz, Poland, Poland |
CORRESPONDING AUTHOR
Łukasz Sokołowski
Department of Obstetrics and Gynaecology, Polish Mother's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338, Łódź, Poland
Department of Obstetrics and Gynaecology, Polish Mother's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338, Łódź, Poland
Submission date: 2022-03-07
Final revision date: 2022-03-27
Acceptance date: 2022-03-28
Online publication date: 2022-04-04
KEYWORDS
risk factorultrasoundprenatal diagnosisfetusfetal echocardiographycongenital diaphragmatic herniaaortafetal heart
TOPICS
ABSTRACT
Introduction:
The aim of this study was to evaluate if selected prenatal markers obtainded from fetal echocardiography can predict postnatal outcome in congenital diaphragmatic hernia (CDH) patients. We also aimed to verify the prognostic value of lung-to-head ratio (LHR).
Material and methods:
The study group included 29 fetuses with CDH. We analyzed potentially prognostic parameters measured using fetal echocardiography and fetal ultrasound. The assessed parameters were compared between the group of patients with CDH who survived to discharge (n=21) and the subset of patients who died before discharge from hospital (n=8).
Results:
In survivors, mean z-score for ascending aorta (AAo) diameter was 0.23 ± 0.98 vs – 1.82 ± 1.04 in patients who died (t-test, p=0.0015). In survivors, the main pulmonary artery/ascending aorta ratio was 1.22 ± 0.17 vs 1.46 ± 0.21 in patients who died (t-test, p=0.017). In survivors, the LHR was 1.81 ± 0.96 vs 0.95 ± 0.6 in patients who died (t-test, p=0.019). In survivors, the observed to expected LHR was 57% ± 30% vs 30% ± 18% in patients who died (t-test, p=0.018).
Conclusions:
Narrowing of the ascending aorta in CDH fetuses is a poor prognostic factor associated with increased mortality in neonates. Our study also confirmed the prognostic value of LHR.
The aim of this study was to evaluate if selected prenatal markers obtainded from fetal echocardiography can predict postnatal outcome in congenital diaphragmatic hernia (CDH) patients. We also aimed to verify the prognostic value of lung-to-head ratio (LHR).
Material and methods:
The study group included 29 fetuses with CDH. We analyzed potentially prognostic parameters measured using fetal echocardiography and fetal ultrasound. The assessed parameters were compared between the group of patients with CDH who survived to discharge (n=21) and the subset of patients who died before discharge from hospital (n=8).
Results:
In survivors, mean z-score for ascending aorta (AAo) diameter was 0.23 ± 0.98 vs – 1.82 ± 1.04 in patients who died (t-test, p=0.0015). In survivors, the main pulmonary artery/ascending aorta ratio was 1.22 ± 0.17 vs 1.46 ± 0.21 in patients who died (t-test, p=0.017). In survivors, the LHR was 1.81 ± 0.96 vs 0.95 ± 0.6 in patients who died (t-test, p=0.019). In survivors, the observed to expected LHR was 57% ± 30% vs 30% ± 18% in patients who died (t-test, p=0.018).
Conclusions:
Narrowing of the ascending aorta in CDH fetuses is a poor prognostic factor associated with increased mortality in neonates. Our study also confirmed the prognostic value of LHR.
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