Prenatal ultrasound in prognosis assessment of congenital diaphragmatic hernia
10.13929/j.1003-3289.201608124
- VernacularTitle:产前超声评估先天性膈疝预后
- Author:
Yiwei XIAO
;
Gang YU
;
Ning SHANG
;
Xiaoyan MA
;
Jiangyu ZHANG
;
Qiuping MA
;
Siwei AN
- Keywords:
Ultrasonography,prenatal;
Congenital diaphragmatic hernia;
Fetus
- From:
Chinese Journal of Medical Imaging Technology
2017;33(4):566-570
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of prenatal ultrasound in prognosis assessment of congenital diaphragmatic hernia.Methods The ultrasonographic features of 65 fetuses with congenital diaphragmatic hernia were analyzed,which were confirmed by after birth surgery or examination.The lung-to-head ratio (LHR) of unaffected side and O/E LHR (LHR compared to normal fetuses on same gestational weeks) were obtained,and then the relationship with the prognosis of neonates were analyzed.Results In 65 cases,45 fetuses survived and 8 fetuses died after surgery,while 12 cases did not undergo surgery and death promptly.Overall mortality was 30.77％ (20/65).In 12 hepatic intrathoracic type of diaphragmatic hernia cases,the mortality rate was 66.67 ％ (8/12).In 53 hepatic intra-abdominal type of diaphragmatic hernia cases,the mortality rate was 22.64 ％ (12/53).In 9 cases combined with other structural abnormalities,there were 8 cases were dead and 6 cases (6/8) with abnormal chest structure.LHR values were from 0.40 to 2.72,the average value was 1.59±0.69.It showed statistical difference on the mortality rate in fetus of congenital diaphragmatic hernia with different LHR (x2 =19.360,P＜0.001),The mortality rate in fetal of congenital diaphragmatic hernia with LHR 1.0 or less was higher than that with LHR ＞1.0.O/E LHR measurement values were from 23％ to 90％ and the average value was (58.25±17.61) ％.It showed statistical difference on the mortality rate in fetus of congenital diaphragmatic hernia with different O/E LHR (x2 15.261,P=0.002).The mortality rate in fetal of congenital diaphragmatic hernia with O/E LHR ≤45 ％ was higher than that with O/E LHR＞45 ％.Conclusion The prenatal ultrasound can be used to diagnose congenital diaphragmatic hernia,and to assess the development of unaffected lung and prognosis.
