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

Congenital diaphragmatic hernia with heart defect has a high risk for hypoplastic left heart syndrome and major extra‐cardiac malformations: 10‐year national cohort from Finland

“…Several studies have shown that the mortality risk in children with CDH is related to several factors: prenatal diagnosis, birthweight, gestational age, five‐minute Apgar score, patch repair, severity of pulmonary hypoplasia and associated congenital malformations (especially heart defects) . Herniation of the liver into the thoracic cavity is an important prognostic factor for CDH severity . In our study, 65% of all CDH cases with major heart defect, had a liver‐up position and, more importantly, liver protrusion into thoracic cavity was found in all HLHS cases.…”

“…Obstructive left‐side heart anomalies were as common (38%) as previously reported . These obstructions in CDH patients may be secondary to impaired left heart filling due to compression of left‐side structures, reduction of left‐side preload due to pulmonary hypoplasia and distortions of the inferior vena cava flow . A large retrospective study of a cohort of fetuses with CDH suggested that it is primarily the compressive effect that leads to the most severe forms of left‐side obstructions.…”

Mortality factors in infants with congenital diaphragmatic hernia: A systematic review

“…Table presents a summary of the seven included studies (Hidaka et al, ; Lazar et al, ; Sananes et al, ; Stranak et al, ; Takahashi et al, ; Yamoto et al, ; Yang et al, ). Data from the same cohort were included in two of these studies (Lazar et al, ; Sananes et al, ) and the most recent study was used for the factors reported in both studies.…”

Characterizing cardiac dysfunction in fetuses with left congenital diaphragmatic hernia

“…Specifically, early diastolic RV function (in the first 2 days of life) has been reported as predictive of early outcomes in CDH . Differences between left‐sided and right‐sided structures, such as the tricuspid‐to‐mitral valve ratio, have shown to be associated with mortality …”

“…structures, such as the tricuspid-to-mitral valve ratio, have shown to be associated with mortality. 30 Although evaluation of fetal cardiac function in CDH is not currently used in clinical practice, such cardiac parameters could be useful in establishing CDH severity and predicting the degree of neonatal pulmonary hypertension. Pulmonary artery diameters have been found to correlate with perinatal mortality, but not with neonatal pulmonary hypertension.…”