[Antenatal prediction of pulmonary hypoplasia and intrauterine treatment by endoscopic fetal tracheal occlusion in severe isolated congenital diaphragmatic hernia]
- Resource Type
- Authors
- Leonardo, Gucciardo; Jan A, Deprest; Pascal, Vaast; Romain, Favre; Denis, Gallot; Cyril, Huissoud; Florence, Bretelle; Joel, Agenor; Alexandra, Benachi; Jacques, Jani; Elise, Done; Tim, van Mieghem; Yves, Ville; Roland, Devlieger
- Source
- Bulletin de l'Academie nationale de medecine. 192(8)
- Subject
- Hernia, Diaphragmatic
Clinical Trials as Topic
Fetoscopy
Infant, Newborn
Organ Size
Magnetic Resonance Imaging
Severity of Illness Index
Ultrasonography, Prenatal
Catheterization
Rats
Trachea
Imaging, Three-Dimensional
Prenatal Diagnosis
Practice Guidelines as Topic
Animals
Humans
Rabbits
Hernias, Diaphragmatic, Congenital
Lung
- Language
- French
- ISSN
- 0001-4079
Congenital diaphragmatic hernia (CDH) affects one in 2500 to 5000 births and can be detected in utero by means of ultrasound screening Associated structural problems aggravate the prognosis. The survival rate is 70% or more for cases managed in tertiary care centers. The commonest causes of neonatal death in this setting are pulmonary hypoplasia and pulmonary hypertension. Prenatal imaging findings can now accurately predict postnatal outcome, based mainly on ultrasound determination of the lung-to-head ratio and liver position. This information can be used to counsel patients. In severe cases, prenatal intervention can reverse pulmonary hypoplasia. We review current data on prenatal prediction of neonatal survival. We also discuss experimental and clinical data on the benefits of fetal tracheal occlusion. The TOTAL trial (Tracheal Occlusion To Accelerate Lung growth) is currently ongoing in Europe.