Journal of Ultrasound in Medicine, Vol 16, Issue 6 407-410, Copyright © 1997 by American Institute of Ultrasound in Medicine
Abdominal circumference in fetuses with congenital diaphragmatic hernia: correlation with hernia content and pregnancy outcome
J. Teixeira, W. Sepulveda, J. Hassan, P. M. Cox and M. P. Singh
Centre for Fetal Care, Royal Postgraduate Medical School, Queen Charlotte's and Chelsea Hospital, London, United Kingdom.
To assess the value of abdominal circumference measurements in the second
trimester as a predictor of mortality in fetuses with congenital
diaphragmatic hernia, 34 fetuses with this condition who had had second
trimester ultrasonographic evaluation were analyzed retrospectively for
abdominal circumference measurements, content of the hernia, and pregnancy
outcome. The abdominal circumference was below the fifth percentile in nine
of the 27 fetuses (33%) with an isolated defect and in five of the seven
fetuses (71%) with additional anomalies. In fetuses with isolated
congenital diaphragmatic hernia, an abdominal circumference measurement
below the fifth percentile was associated with the presence of the liver (P
< 0.05) but not of the stomach in the chest. In 19 continuing
pregnancies with an isolated defect, all five fetuses with an abdominal
circumference below the fifth percentile either died prenatally (n = 1),
soon after birth (n = 1), or after surgery (n = 3). In contrast, only six
of the 14 fetuses (43%) with an abdominal circumference measurement within
the normal range died, either soon after birth (n = 2) or after surgery (n
= 4) (P < 0.05). We conclude that an abdominal circumference measurement
below the fifth percentile in the second trimester appears to be a good
predictor of a poor prognosis in fetuses with congenital diaphragmatic
hernia.
