The relationship between three signs of fetal magnetic resonance imaging and severity of congenital diaphragmatic hernia

Objective: To seek a simple approach for prenatally classifying congenital diaphragmatic hernia (CDH) severity using fetal magnetic resonance imaging (MRI) markers. Study design: A retrospective, multicenter study using questionnaires to investigate fetal MRI findings. We included fetuses prenatally...

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Bibliographic Details
Published in:Journal of perinatology 2017-03, Vol.37 (3), p.265-269
Main Authors: Hattori, T, Hayakawa, M, Ito, M, Sato, Y, Tamakoshi, K, Kanamori, Y, Okuyama, H, Inamura, N, Takahashi, S, Fujino, Y, Taguchi, T, Usui, N
Format: Article
Language:English
Subjects:
692/499
692/53/2423
Childrens health
Confidence intervals
Diaphragm
Diaphragmatic hernia
Extracorporeal membrane oxygenation
Female
Fetus - diagnostic imaging
Fetuses
Genetic disorders
Gestational Age
Hernia
Hernias
Hernias, Diaphragmatic, Congenital - diagnostic imaging
Hernias, Diaphragmatic, Congenital - mortality
Hospitals
Humans
Infant, Newborn
Intensive care
Investigations
Japan
Liver - diagnostic imaging
Logistic Models
Lung - diagnostic imaging
Lungs
Magnetic Resonance Imaging
Male
Maternal & child health
Medical imaging
Medical prognosis
Medicine
Medicine & Public Health
Methods
Morphology
Neonatal care
Nitric oxide
original-article
Pediatric Surgery
Pediatrics
Physiological aspects
Pregnancy
Prenatal Care
Prenatal Diagnosis - methods
Questionnaires
Resonance
Retrospective Studies
Severity of Illness Index
Stomach - diagnostic imaging
Surgery
Survival
University graduates
Ventilators
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Summary:Objective: To seek a simple approach for prenatally classifying congenital diaphragmatic hernia (CDH) severity using fetal magnetic resonance imaging (MRI) markers. Study design: A retrospective, multicenter study using questionnaires to investigate fetal MRI findings. We included fetuses prenatally diagnosed with isolated left-sided CDH and delivered after 36 weeks of gestation. We focused on three fetal MRI morphological signs: incomplete pulmonary baseline (IPB), liver up (LU) and retrocardiac stomach (RCS). We also evaluated the fetal MRI score defined as the total number of positive signs; the primary outcome was survival at discharge. Results: In 256 patients (from 56 institutions), IPB, LU and RCS findings correlated with lower survival: odds ratio (95% confidence interval), 0.16 (0.08 to 0.33); 0.24 (0.12 to 0.51); and 0.14 (0.07 to 0.28); respectively. Patients with higher fetal MRI scores had a higher mortality rate. Conclusion: IPB, LU and RCS on fetal MRI are related to CDH severity.
ISSN:0743-8346
1476-5543
DOI:10.1038/jp.2016.208