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Re‐evaluation of stomach position as a simple prognostic factor in fetal left congenital diaphragmatic hernia: a multicenter survey in Japan
Ultrasound in obstetrics & gynecology, 2011-03, Vol.37 (3), p.277-282
Kitano, Y.
Okuyama, H.
Saito, M.
Usui, N.
Morikawa, N.
Masumoto, K.
Takayasu, H.
Nakamura, T.
Ishikawa, H.
Kawataki, M.
Hayashi, S.
Inamura, N.
Nose, K.
Sago, H.
2011
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Kitano, Y.
Okuyama, H.
Saito, M.
Usui, N.
Morikawa, N.
Masumoto, K.
Takayasu, H.
Nakamura, T.
Ishikawa, H.
Kawataki, M.
Hayashi, S.
Inamura, N.
Nose, K.
Sago, H.
Titel
Re‐evaluation of stomach position as a simple prognostic factor in fetal left congenital diaphragmatic hernia: a multicenter survey in Japan
Ist Teil von
Ultrasound in obstetrics & gynecology, 2011-03, Vol.37 (3), p.277-282
Ort / Verlag
Chichester, UK: John Wiley & Sons, Ltd
Erscheinungsjahr
2011
Quelle
Elektronische Zeitschriftenbibliothek - Freely accessible e-journals
Beschreibungen/Notizen
Objectives To document outcome and to explore prognostic factors in fetal left congenital diaphragmatic hernia (CDH). Methods This was a multicenter retrospective study of 109 patients with prenatally diagnosed isolated left CDH born between 2002 and 2007. The primary outcome was intact discharge, defined as discharge from hospital without major morbidities, such as a need for respiratory support including oxygen supplementation, tube feeding, parenteral nutrition or vasodilators. All patients were managed at perinatal centers with immediate resuscitation, gentle ventilation (mostly with high‐frequency oscillatory ventilation) and surgery after stabilization. Prenatal data collected included liver and stomach position, lung‐to‐head ratio, gestational age at diagnosis and presence or absence of polyhydramnios. Stomach position was classified into four grades: Grade 0, abdominal; Grade 1, left thoracic; Grade 2, less than half of the stomach herniated into the right chest; and Grade 3, more than half of the stomach herniated into the right chest. Results Overall intact discharge and 90‐day survival rates were 65.1% and 79.8%, respectively. Stomach herniation was classified as Grade 0 in 19.3% of cases, Grade 1 in 45.9%, Grade 2 in 13.8% and Grade 3 in 21.1%. Multivariate analysis revealed that liver position was the strongest prognostic variable for intact discharge, followed by stomach position. Based on our results, we divided patients into three groups according to liver (up vs. down) and stomach (Grade 0–2 vs. Grade 3) position. Intact discharge rates declined significantly from liver‐down (Group I), to liver‐up with stomach Grade 0–2 (Group II), to liver‐up with stomach Grade 3 (Group III) (87.0%, 47.4% and 9.5% of cases, respectively). Conclusion Current status and outcomes of prenatally diagnosed left CDH in Japan were surveyed. Stomach herniation into the right chest was not uncommon and its grade correlated with outcome. The combination of liver and stomach positions was useful to stratify patients into three groups (Group I–III) with different prognoses. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Sprache
Englisch
Identifikatoren
ISSN: 0960-7692, 1469-0705
eISSN: 1469-0705
DOI: 10.1002/uog.8892
Titel-ID: cdi_proquest_miscellaneous_853225549
Format
–
Schlagworte
Biological and medical sciences
,
Chest
,
congenital diaphragmatic hernia
,
Data processing
,
Female
,
fetus
,
Fetuses
,
Firing rate
,
gentle ventilation
,
Gestational Age
,
Gynecology
,
Gynecology. Andrology. Obstetrics
,
Hernia
,
Hernia, Diaphragmatic - diagnostic imaging
,
Hernia, Diaphragmatic - embryology
,
Hernia, Diaphragmatic - mortality
,
Hernias, Diaphragmatic, Congenital
,
Hospitals
,
Humans
,
Infant, Newborn
,
Japan - epidemiology
,
Liver
,
Male
,
Medical sciences
,
Morbidity
,
Multivariate analysis
,
Obstetrics
,
Oxygen
,
Parenteral nutrition
,
Predictive Value of Tests
,
Pregnancy
,
Pregnancy Outcome
,
Prognosis
,
Respiration, Artificial
,
Retrospective Studies
,
Stomach
,
Stomach - anatomy & histology
,
Stomach - diagnostic imaging
,
Stomach - embryology
,
Survival
,
Survival Rate
,
Thorax
,
Ultrasonography, Prenatal - methods
,
Ultrasound
,
Vasodilators
,
Ventilation
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