Cardiac fetal ultrasonographic parameters for predicting outcomes of isolated left-sided congenital diaphragmatic hernia

Background: The purpose of this study was to investigate fetal cardiac ultrasonographic parameters in relation to the outcomes of patients with isolated left-sided congenital diaphragmatic hernia (CDH). Methods: Subjects comprised 33 fetuses with fetal CDH and 99 control fetuses without cardiac and lung anomalies. Three parameters, cardiothoracic area ratio (CTAR), the ratio of the diameter of the main pulmonary artery to that of the ascending aorta (MPA/AAo), and the ratio of the diameter of the tricuspid valve to that of the mitral valve (TV/MV) were compared between fetal CDH and control subjects and between survival (SG) and non-survival (NSG) groups. Results: All three parameters differed significantly between CDH and control fetuses. Significant differences between SG and NSG were observed in CTAR and TV/MV ratio, but not in MPA/AAo ratio before and after 32 gestational weeks. A significant increase in the TV/MV ratio was noted along with an increase in gestational age. A TV/MV ratio of > 1.72 discriminated non-survivors from survivors with better sensitivity and specificity. Conclusions: Fetal cardiac ultrasonography provides useful information for predicting the outcomes of isolated left-sided CDH. The TV/MV ratio was considered a reliable indicator that reflected outcomes of isolated left-sided CDH. (c) 2015 Elsevier Inc. All rights reserved.