Novel Risk Score for Fetuses with Congenital Diaphragmatic Hernia Based on Ultrasound Findings

Eur J Pediatr Surg DOI: 10.1055/s-0039-1698768 Introduction We aimed to establish and validate a risk score for fetuses with congenital diaphragmatic hernia (CDH) using only prenatal ultrasound findings. Material and Methods Derivation (2011–2016, n = 350) and validation (2006–2010, n = 270) cohorts were obtained from a Japanese CDH study group database. Using a logistic regression analysis, we created a prediction model and weighted scoring system from the derivation dataset and calculated the odds ratio of an unsatisfactory prognosis (death within 90 days of life or hospitalization duration exceeding 180 days). Five adverse prognostic factors obtained using prenatal ultrasound, including an observed/expected lung area-to-head circumference ratio (o/eLHR)
Source: European Journal of Pediatric Surgery - Category: Surgery Authors: Tags: Original Article Source Type: research

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Prenatal risk assessment of congenital diaphragmatic hernia (CDH) relies on prenatal ultrasound (U/S) and fetal magnetic resonance imaging (MRI). When the modalities differ in prognosis, it is unclear which is more reliable.
Source: Journal of Pediatric Surgery - Category: Surgery Authors: Source Type: research
Publication date: June 2019Source: Journal of Pediatric Surgery Case Reports, Volume 45Author(s): Anna Hyvärinen, Ulla Sankilampi, Erja Tyrväinen, Kari VanamoAbstractCongenital diaphragmatic hernia (CDH) occurs in approximately one of 3500 live births. It includes a congenital defect of the diaphragm through which bowel and other abdominal organs herniate into the thoracic cavity. Pulmonary hypoplasia is an essential feature of the anomaly, with related overload of the right side of the heart. Most CDHs can be sutured directly after initial stabilization of the cardiopulmonary condition. However, in diaphragmatic...
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
Publication date: Available online 22 April 2019Source: Journal of Pediatric Surgery Case ReportsAuthor(s): Anna Hyvärinen, Ulla Sankilampi, Erja Tyrväinen, Kari VanamoAbstractCongenital diaphragmatic hernia (CDH) occurs in approximately one of 3500 live births. It includes a congenital defect of the diaphragm through which bowel and other abdominal organs herniate into the thoracic cavity. Pulmonary hypoplasia is an essential feature of the anomaly, with related overload of the right side of the heart. Most CDHs can be sutured directly after initial stabilization of the cardiopulmonary condition. However, in dia...
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
AbstractBackgroundThe presence of a hernia sac in congenital diaphragmatic hernia (CDH) has been reported to be associated with higher lung volumes and better postnatal outcomes.ObjectiveTo compare prenatal imaging (ultrasound and MRI) prognostic measurements and postnatal outcomes of CDH with and without hernia sac.Materials and methodsWe performed database searches from January 2008 to March 2017 for surgically proven cases of CDH with and without hernia sac. All children had a detailed ultrasound (US) examination and most had an MRI examination. We reviewed the medical records of children enrolled in our Pulmonary Hypop...
Source: Pediatric Radiology - Category: Radiology Source Type: research
We describe a 12-year-old girl who presented to our emergency department with acute epigastric pain and non-bilious vomiting. An incidental finding of diaphragmatic hernia with hugely dilated stomach was diagnosed by plain X ray, Ultrasound (US) and Computed tomography (CT) abdomen with oral contrast. She underwent laparotomy and gastric volvulus was found. Reduction of the viscera to the abdominal cavity and repair of diaphragmatic defect was done. She recovered with accepted general condition and was discharged five days later.
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
Conclusions: Markers of evolution of CLM are difficult to homogenize. Clinical registries may help design more comprehensive care.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric bronchology Source Type: research
ConclusionThere was good concordance between ultrasound findings and operative findings regarding the size of the defect and presence or absence of the diaphragm rim.
Source: Pediatric Radiology - Category: Radiology Source Type: research
Prenatal observed/expected lung –to-head ratio (O/E LHR) by ultrasound correlates with postnatal mortality for congenital diaphragmatic hernia (CDH) patients. The aim of this study is to determine if O/E LHR correlates with pulmonary hypertension (PH) outcomes for CDH patients.
Source: Journal of Pediatric Surgery - Category: Surgery Authors: Source Type: research
In congenital diaphragmatic hernia (CDH), herniation of the abdominal organs into the fetal chest causes pulmonary hypoplasia and pulmonary hypertension, the main causes of neonatal mortality. As antenatal ultrasound screening improves, the risk of postnatal death can now be better predicted, allowing for the identification of fetuses that might most benefit from a prenatal intervention. Fetoscopic tracheal occlusion is being evaluated in a large international randomized controlled trial. We will present the antenatal imaging approaches that can help identify fetuses that might benefit from antenatal therapy, and will revi...
Source: Seminars in Pediatric Surgery - Category: Pediatrics Authors: Source Type: research
We present the antenatal imaging approaches that can help identify fetuses that might benefit from antenatal therapy, and review the evolution of fetal surgery for CDH to date.
Source: Seminars in Pediatric Surgery - Category: Pediatrics Authors: Source Type: research
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