Pediatric Surgery International

, Volume 27, Issue 1, pp 39–45

Reliability of the lung to thorax transverse area ratio as a predictive parameter in fetuses with congenital diaphragmatic hernia

  • Noriaki Usui
  • Yoshihiro Kitano
  • Hiroomi Okuyama
  • Mari Saito
  • Nobuyuki Morikawa
  • Hajime Takayasu
  • Tomoo Nakamura
  • Satoshi Hayashi
  • Motoyoshi Kawataki
  • Hiroshi Ishikawa
  • Keisuke Nose
  • Noboru Inamura
  • Kouji Masumoto
  • Haruhiko Sago
Original Article

DOI: 10.1007/s00383-010-2725-z

Cite this article as:
Usui, N., Kitano, Y., Okuyama, H. et al. Pediatr Surg Int (2011) 27: 39. doi:10.1007/s00383-010-2725-z

Abstract

Purpose

An accurate prenatal assessment of the patients’ severity is essential for the optimal treatment of individuals with congenital diaphragmatic hernia (CDH). The purpose of this study was to clarify the reliability of the lung to thorax transverse area ratio (L/T) as a prenatal predictive parameter.

Methods

A multicenter retrospective cohort study was conducted on 114 isolated CDH fetuses with a prenatal diagnosis during the period between 2002 and 2007 at five participating centers in Japan. The relationship between the gestational age and the L/T was analyzed. The most powerful measurement point and accurate cutoff value of the L/T was determined by an analysis of a receiver operating characteristic curve, which was verified by comparing the patients’ severity.

Results

There was a negative correlation between the gestational age and the L/T in the non-survivors, and no correlation in the survivors. There were significant differences in the parameters which represented the patients’ severity including the respiratory and circulatory status, the surgical findings, and the final outcomes between the groups divided at 0.080 in the minimum value of the L/T during gestation.

Conclusion

The L/T was not strongly influenced by the gestational age, and it was found to be a reliable prenatal predictive parameter in fetuses with isolated CDH.

Keywords

Congenital diaphragmatic hernia Prenatal diagnosis Predictive parameter Prognostic factor Pulmonary hypertension Severity 

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Noriaki Usui
    • 1
  • Yoshihiro Kitano
    • 2
  • Hiroomi Okuyama
    • 5
  • Mari Saito
    • 3
  • Nobuyuki Morikawa
    • 2
  • Hajime Takayasu
    • 2
  • Tomoo Nakamura
    • 4
  • Satoshi Hayashi
    • 4
  • Motoyoshi Kawataki
    • 6
  • Hiroshi Ishikawa
    • 6
  • Keisuke Nose
    • 7
  • Noboru Inamura
    • 8
  • Kouji Masumoto
    • 9
  • Haruhiko Sago
    • 4
  1. 1.Department of Pediatric SurgeryOsaka University Graduate School of MedicineOsakaJapan
  2. 2.Division of SurgeryNational Center for Child Health and DevelopmentTokyoJapan
  3. 3.Division of Clinical ResearchNational Center for Child Health and DevelopmentTokyoJapan
  4. 4.Division of Maternal-Fetal and Neonatal MedicineNational Center for Child Health and DevelopmentTokyoJapan
  5. 5.Department of Pediatric SurgeryHyogo College of MedicineHyogoJapan
  6. 6.Department of Perinatal CareKanagawa Children’s Medical CenterYokohamaJapan
  7. 7.Department of Pediatric SurgeryOsaka Medical Center and Research Institute for Maternal and Child HealthOsakaJapan
  8. 8.Department of Pediatric CardiologyOsaka Medical Center and Research Institute for Maternal and Child HealthOsakaJapan
  9. 9.Department of Pediatric SurgeryKyushu UniversityFukuokaJapan

Personalised recommendations