Prenatal lung-head ratio: threshold to predict outcome for congenital diaphragmatic hernia

Objective: The literature suggests that lung-head ratio (LHR) and liver position may inconsistently predict outcome for congenital diaphragmatic hernia (CDH). We reviewed our inborn neonates with isolated left-sided CDH to determine whether these variables predicted survival and to estimate the opti...

Full description

Saved in:
Bibliographic Details
Published in:The journal of maternal-fetal & neonatal medicine 2012-07, Vol.25 (7), p.1011-1016
Main Authors: Aspelund, Gudrun, Fisher, Jason C., Simpson, Lynn L., Stolar, Charles J. H.
Format: Article
Language:English
Subjects:
Congenital diaphragmatic hernia
Female
Head - diagnostic imaging
Hernia, Diaphragmatic - diagnostic imaging
Hernia, Diaphragmatic - mortality
Hernias, Diaphragmatic, Congenital
Humans
Liver - diagnostic imaging
Lung - diagnostic imaging
lung-head ratio
Male
New York City - epidemiology
Pregnancy
Retrospective Studies
survival
Ultrasonography, Prenatal
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective: The literature suggests that lung-head ratio (LHR) and liver position may inconsistently predict outcome for congenital diaphragmatic hernia (CDH). We reviewed our inborn neonates with isolated left-sided CDH to determine whether these variables predicted survival and to estimate the optimal LHR threshold. Methods: Prenatal LHR and liver position were obtained from 2002 to 2009. The primary endpoint was survival. Results: LHR was greater in survivors after adjusting for gestational age (median 1.40 versus 0.81; p  0.85 predicted survival after adjustment for gestational age (OR = 33.6, 95% CI = 5.4-209.5). Liver position did not predict survival. Conclusions: Prenatal LHR >0.85 predicts survival for infants with isolated left-sided CDH without compromising discrimination of survivors from non-survivors. The diagnostic utility of LHR may be confounded by gestational age at measurement. Stringent LHR threshold may minimize false-negative attribution and improve utility of this measurement as predictor of survival.
ISSN:1476-7058
1476-4954
DOI:10.3109/14767058.2011.608442