Journal of Ultrasound in Medicine, Vol 19, Issue 12 845-848, Copyright © 2000 by American Institute of Ultrasound in Medicine
Congenital diaphragmatic hernia without herniation of the liver: does the lung-to-head ratio predict survival?
L. Sbragia, B. W. Paek, R. A. Filly, M. R. Harrison, J. A. Farrell, D. L. Farmer and C. T. Albanese
The Fetal Treatment Center, Department of Surgery, University of California, San Francisco 94143-0570, USA.
The purpose of the present study was to determine the ability of
lung-to-head ratio to predict survival and need for extracorporeal membrane
oxygenation support in fetuses with left congenital diaphragmatic hernia
without herniation of the liver into the chest. The perinatal records of 20
fetuses with isolated left congenital diaphragmatic hernia without
herniation of the left lobe of the liver into the chest were reviewed.
Fetuses were stratified into two groups depending on lung-to-head ratio:
those with a ratio of less than 1.4 (historically a poor prognosis group)
and those with a ratio of greater than 1.4. The outcome of both groups was
compared with chi-square analysis. Eight of 11 fetuses with a lung-to-head
ratio greater than 1.4 survived, whereas 8 of 9 fetuses with a ratio of
less than 1.4 survived. No differences were noted in the need for
extracorporeal membrane oxygenation support or survival between the two
groups. Fetuses with a prenatally diagnosed left congenital diaphragmatic
hernia without herniation of liver into the chest have a favorable
prognosis even in the presence of a low lung-to-head ratio.
