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Tracheal diameter at birth in severe congenital diaphragmatic hernia treated by fetal endoscopic tracheal occlusion.
MedLine Citation:
PMID:  21671461     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To investigate tracheal dimensional differences seen at birth following fetal endoscopic tracheal occlusion (FETO) in cases of severe congenital diaphragmatic hernia (CDH) and to report on their clinical follow-up. PATIENTS AND METHODS: In chest X-rays, taken within 48 h after birth, we measured the tracheal diameter at the level of the tracheal entry into the chest, 1 cm above the level of the carina and at middistance between these sites in 37 fetuses with severe CDH treated by FETO. These measurements were compared with those in 74 preterm and term neonates with no congenital lung abnormalities. RESULTS: In the CDH group, compared to the controls, the tracheal diameter corrected for gestational age was significantly larger at all three levels of the trachea. Regression analysis showed that significant predictors of the tracheal diameter at the level of tracheal entry into the chest were the observed to expected (o/e) lung area to head circumference ratio (LHR) and the duration of tracheal occlusion. In the CDH group, postnatal follow-up until the age of 22 months (1-70) showed that 5 of 24 neonates had an effort-induced barking cough. CONCLUSION: A large number of infants with severe CDH surviving after FETO have a degree of tracheomegaly that is associated with the severity of CDH as assessed by pre-FETO LHR. This tracheomegaly does not constitute an obvious clinical problem. Copyright © 2011 John Wiley & Sons, Ltd.
Authors:
J Jani; C Valencia; M Cannie; A Vuckovic; M Sellars; K H Nicolaides
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-14
Journal Detail:
Title:  Prenatal diagnosis     Volume:  -     ISSN:  1097-0223     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 John Wiley & Sons, Ltd.
Affiliation:
University Hospital Brugmann, Brussels, Belgium.
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