P18.08: Lung growth in fetuses with left‐sided congenital diaphragmatic hernia evaluated by three dimensional ultrasonography

Abstract

To evaluate fetal lung growth in fetuses with isolated left-sided congenital diaphragmatic hernia (CDH) using three dimensional ultrasonography. Fetal right (RLV) and total lung volumes (TLV) were serially evaluated in 66 healthy fetuses and 52 fetuses with left-sided CDH by three dimensional ultrasonography between 20 and 37 weeks of menstrual age [MA]. Functions fitted to these size parameters were compared for three groups: 1) healthy versus CDH fetuses; 2) different severities of CDH; and 3) CHD fetuses that survived versus those that died. Fetal RLV and TLV as well as the fetal observed-to-expected right and total lung volume ratios (o/e-RLV and o/e-TLV, respectively) were significantly lower in fetuses with CDH than healthy fetuses (p < 0.001), in moderate and severe forms (p < 0.001) and in those fetuses with CDH that died (p < 0.001). The o/e-RLV and o/e-TLV did not vary according menstrual age in healthy fetuses and in those with CDH, independent of the severity of the disease and mortality. Fetal lung volumes have similar growth pattern in fetuses with CDH and healthy fetuses, independently of the severity and outcome. The o/e-RLV and o/e-TLV are constant throughout pregnancy in healthy fetuses and those with left-sided CDH, suggesting that these ratios may be useful in predicting outcome in those fetuses independent of the menstrual age.