| Timing of lung size assessment in the prediction of survival in fetuses with diaphragmatic hernia. | |
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MedLine Citation:
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PMID: 18069722 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To investigate whether the prediction of postnatal outcome of fetuses with isolated congenital diaphragmatic hernia depends on the gestational age at assessment using the fetal observed to expected (O/E) lung area to head circumference ratio (LHR), by comparing the performance of the test at 22-23 weeks with that at 32-33 weeks of gestation. METHODS: Following prenatal diagnosis of isolated diaphragmatic hernia before 22 weeks, we evaluated the O/E LHR at 22-32 weeks and again at 32-33 weeks of gestation. Only cases liveborn beyond 34 weeks of gestation and with postnatal follow-up available until discharge from the hospital were included. Regression analysis was used to examine the effect on postnatal survival of O/E LHR, gestational age at delivery, side of the diaphragmatic hernia and intrathoracic position of the liver. Wilcoxon rank test for paired samples was used to compare median O/E LHR at 22-23 weeks and 32-33 weeks, in babies who survived and in those who died. Receiver-operating characteristics (ROC) curves were constructed for the prediction of survival by O/E LHR at 22-23 weeks and at 32-33 weeks. RESULTS: In total, 53 pairs of measurements could be assessed. Univariate logistic regression analysis demonstrated that significant predictors of survival were the presence or absence of intrathoracic herniation of the liver, the O/E LHR at 22-23 weeks and the O/E LHR at 32-33 weeks of gestation. Multivariate logistic regression analysis demonstrated that only O/E LHR at 22-23 weeks or 32-33 weeks provided significant independent prediction of survival. The median O/E LHR at 22-23 weeks was not significantly different from that at 32-23 weeks either in survivors or in babies that subsequently died in the neonatal period (P = 0.25 and P = 0.09, respectively). The area under the ROC curve for prediction of postnatal survival from the O/E LHR at 22-23 weeks was 0.789 (P < 0.001) and that for prediction from the O/E LHR at 32-33 weeks was 0.842 (P < 0.001). CONCLUSIONS: In isolated diaphragmatic hernia, O/E LHR measurement at 22-23 weeks as well as at 32-33 weeks provides useful independent prediction of subsequent survival. The prediction of postnatal survival using O/E LHR is independent of the timing of assessment. |
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Authors:
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J Jani; K H Nicolaides; A Benachi; O Moreno; R Favre; E Gratacos; J Deprest |
Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: 31 ISSN: 0960-7692 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2007-12-27 Completed Date: 2008-05-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: England |
Other Details:
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Languages: eng Pagination: 37-40 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Fetal Medicine Units of University Hospital Gasthuisberg, Leuven, Belgium. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cephalometry
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methods Female Gestational Age Head / ultrasonography* Hernia, Diaphragmatic / ultrasonography* Humans Infant, Newborn Lung / ultrasonography* Male Predictive Value of Tests Pregnancy Pregnancy Outcome Pregnancy Trimester, Third Retrospective Studies Survival Analysis Ultrasonography, Prenatal / methods |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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