OP27.01: Prediction of neonatal outcome in 20 fetuses with severe left congenital diaphragmatic hernia submitted to percutaneous fetal tracheal occlusion by the observed/expected fetal lung volumes

Abstract

To evaluate the potential use of the observed/expected total fetal lung volumes (o/e-FLV) for the prediction of neonatal outcome in severe left congenital diaphragmatic hernia (CDH) after fetal tracheal occlusion (FETO). Between January 2006 and December 2009, 20 fetuses with severe, isolated left CDH (LHR < 1.0 and liver-up) were submitted to FETO between 26–30 weeks of gestation. The o/e-FLV was evaluated by the VOCALTM system on three-dimensional ultrassonography before (26–28 ws) and after (32 ws) FETO procedure and then correlated with neonatal outcome (deaths). Neonatal deaths occurred in 9/20 (45.0%) cases. Significantly lower values of o/e-FLV were observed in those cases that died before (0.19 ± 0.09) and after (0.22 ± 0.15) FETO procedures in comparison to those that survived (0.22 ± 0.11 and 0.38 ± 0.21; respectively, P < 0.01). The o/e-FLV may be useful to predict neonatal outcome in fetuses with severe left CDH submitted to FETO procedures.