IN FETUSES WITH ISOLATED CONGENITAL DIAPHRAGMATIC HERNIA: A MULTICENTER STUDY JACQUES JANI, ALEXANDRA BENACHI, DELPHINE MITANCHEZ, KAREL ALLEGAERT, DICK TIBBOEL, OSCAR MORENO, VERED EISENBERG, KYPROS NICOLAIDES, EDOUARDO GRATACOS, ARNO VAN HEIJST, LAURENT STORME, JACQUELINE MATIS, JAN DEPREST, University Hospital Leuven, Obstetrics and Gynecology, Leuven, Belgium, Hopital Necker-Enfants Malades, Obstetrics and Gynecology, Paris, France, Hopital Necker-Enfants Malades, Neonatology, Paris, France, University Hospital Leuven, Neonatology, Leuven, Belgium, Erasmus University Children’s Hospital, Neonatology, Rotterdam, Netherlands, Hospital Clinic, Obstetrics and Gynecology, Barcelona, Spain, Ben-Gurion University of the Negev, Jerusalem, Israel, Kingis College Hospital, Harris Birthright Research Centre, London, United Kingdom, UMC Sint Radboud, Neonatology, Nijmegen, Netherlands, CHRU de Lille, Department of perinatology, Lille, France, CHRU Strasbourg, Neonatology, Schiltigheim, France OBJECTIVE: To investigate the value of antenatally determined fetal lung area to head circumference ratio (LHR) and liver position in the prediction of the neonatal morbidity in isolated congenital diaphragmatic hernia (CDH) earlier described in a neonatal mortality study (Jani 2006). STUDY DESIGN: Retrospective multicentre study including consecutive fetuses diagnosed with isolated CDH from 2000 onwards, where LHR measurements and liver position were available, and who were expectantly managed and alive at discharge from the neonatal intensive case unit (NICU). Fetuses were divided in 4 groups (LHR!1.4; LHRR1.4 and liver up or down for each). Outcome measures were gestational age (GA) at prenatal assessment and birth, number of days in NICU, days on conventional or high frequency ventilation (HFV), need for patch repair, days of start of enteral feeding, duration for O2 need and anti-reflux medication at discharge. Data are represented as meanGSD or % where appropriate. RESULTS: 93 fetuses (4 right-sided and 89 left-sided) were eligible. Mean GA at assessment was 27.9 G 4.7 (range 20.0-39.0) wks and at delivery 38.7 G 1.4 (range 34.0-41.4) wks. There was only 1 survivor with LHR!1.0 and liver up with typical morbidity. Fetuses with LHR !1.4 and liver up had a higher patch rate (44.4%), longer NICU stay (51.3 G 27.7 days), need for conventional ventilation (25.7 G 12.6 d) and oxygen support (35.3 G 18.7 d) compared to fetuses with LHR R1.4 and liver down (Table). CONCLUSION: In isolated CDH, studied postnatal morbidity parameters were related to known prenatal predictors of mortality. Fetuses with LHR !1.4 and liver up have an increased need for patch repair, longer NICU stay, and higher ventilatory as well as oxygen needs.