Erratum: Procedure-Related Complications and Survival Following Fetoscopic Endotracheal Occlusion (FETO) for Severe Congenital Diaphragmatic Hernia: Systematic Review and Meta-Analysis in the FETO Era

Tonni, Gabriele; Martins, W.P.; Ruano, Rodrigo; Júnior, Edward Araujo

doi:10.1055/s-0036-1592407

Cited by 4 publications

(2 citation statements)

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“…CDH can be classified as severe, moderate and mild. The potential of the plug strategy demonstrated in this study is applicable to FETO in fetuses with severe pulmonary hypoplasia, as this was the focus of all studies and data used in our model 2,[38][39][40] . A trial focusing on moderate CDH patients showed that FETO does not significantly increase survival to discharge (P = 0.06), while increasing the risk of PPROM and PTD 9 .…”

Section: Discussionmentioning

confidence: 99%

Plugging membranes after fetoscopy in congenital diaphragmatic hernia: early cost‐effectiveness analysis

Janssen¹,

Drongelen²,

Daamen

et al. 2023

Ultrasound in Obstet & Gyne

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Objectives Fetal endoscopic tracheal occlusion (FETO) improves neonatal survival of fetuses with congenital diaphragmatic hernia (CDH). However, FETO also increases the risk of preterm prelabor rupture of membranes (PPROM) and preterm delivery (PTD), as fetal membrane defects after fetoscopy do not heal. To solve this issue, an advanced sealing plug for closing the membrane defect is being developed. Using early‐stage health economic modeling, we aimed to estimate the potential value of this innovative plug in terms of costs and effects, and to determine the properties required for it to become cost‐effective. Methods Early‐stage health economic modeling was applied to the case of performing FETO in women with a singleton pregnancy whose fetus is diagnosed prenatally with CDH. We simulated a cohort of patients using a state‐transition model over a 45‐year time horizon. In our best‐case‐scenario analysis, we compared the current‐care strategy with the perfect‐plug strategy, which reduces the risk of PPROM and PTD by 100%, to determine the maximum quality‐adjusted life years (QALYs) gained and costs saved. Using threshold analysis, we determined the minimum percentage reduction in the risk of PPROM and PTD required for the plug to be considered cost‐effective. The impact of model parameters on outcome was investigated using a sensitivity analysis. Results Our model indicated that a perfect‐plug strategy would yield on average an additional 1.94 QALYs at a cost decrease of €2554 per patient. These values were influenced strongly by the percentage of cases with early PTD (27–34 weeks). Threshold analysis showed that, for €500 per plug, the plug strategy needs a minimum percentage reduction of 1.83% in the risk of PPROM and PTD (i.e. reduction in the risk from 47.50% to 46.63% for PPROM and from 71.50% to 70.19% for PTD) to be cost‐effective. Conclusions Our model‐based approach showed clear potential of the plug strategy when applied in the context of FETO for CDH fetuses, as only a minor reduction in the risk of PPROM and PTD is needed for the plug to be cost‐effective. Its value is expected to be even higher when used in conditions associated with a higher rate of early PTD. Continued investment in research and development of the plug strategy appears to provide value for money. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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Section: Discussionmentioning

confidence: 99%

Plugging membranes after fetoscopy in congenital diaphragmatic hernia: early cost‐effectiveness analysis

Janssen¹,

Drongelen²,

Daamen

et al. 2023

Ultrasound in Obstet & Gyne

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“…[26][27][28] A LHR <1 has been correlated with an increased rate of mortality, need for ECMO, and incidence of chronic lung disease. 6,11,29 As the fetus grows with advancing gestation, lung volumes increase at different rates compared to the head circumference; thus, the calculated LHR may show small differences at different gestational ages. 22 Some researchers have proposed using o/e-LHR to evaluate fetal lung development as it has been reported to better reflect survival rates, with higher values correlating with an increased rate of survival.…”

Section: Prenatal Ultrasound Imagingmentioning

confidence: 99%

Predicting Perinatal Outcomes in Fetuses with Congenital Diaphragmatic Hernia Using Ultrasound and Magnetic Resonance Imaging

Huang

Liu

et al. 2021

Maternal-Fetal Medicine

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Congenital diaphragmatic hernia is a congenital fetal disease, which mainly causes pulmonary hypoplasia and pulmonary hypertension. Effective early prenatal diagnosis can detect and predict the prognosis of congenital diaphragmatic hernia in infants, thus provide a reference for prenatal counseling, early intervention, and potential choices for the child's family. Ultrasound and magnetic resonance imaging are the most commonly used methods for non-invasive examination of the fetus. This paper discusses evaluation parameters based on these two imaging modalities.

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Antenatal management of congenital diaphragmatic hernia: What's next ?

et al. 2022

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Congenital diaphragmatic hernia can be diagnosed in the prenatal period and its severity can be measured by fetal imaging. There is now level I evidence that, in selected cases, Fetoscopic Endoluminal Tracheal Occlusion with a balloon increases survival to discharge from the neonatal unit as well as the risk for prematurity. Both effects are dependent on the time point of tracheal occlusion. Fetoscopic Endoluminal Tracheal Occlusion may also lead to iatrogenic death when the balloon cannot be timely retrieved. The implementation of the findings from our clinical studies, may also vary based on local conditions. These may be different in terms of available skill set, access to fetal therapy, as well as outcome based on local neonatal management. We encourage prior benchmarking of local outcomes with optimal postnatal management, based on large enough numbers and using identical criteria as in the recent trials. We propose to work further on prenatal prediction methods, and the improvement of fetal intervention. In this manuscript, we describe a research agenda from a fetal medicine perspective. This research should be in parallel with innovation in neonatal and pediatric (surgical) management of this condition. Kypros H. Nicolaides and Jan Deprest have contributed equally to this manuscript.

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Erratum: Procedure-Related Complications and Survival Following Fetoscopic Endotracheal Occlusion (FETO) for Severe Congenital Diaphragmatic Hernia: Systematic Review and Meta-Analysis in the FETO Era

Abstract: It has been brought to our attention that the name of Edward Araujo Júnior was indexed incorrectly in the above article published online on August 14, 2016, in the European Journal of Pediatric Surgery

Cited by 4 publications

References 0 publications

Plugging membranes after fetoscopy in congenital diaphragmatic hernia: early cost‐effectiveness analysis

Plugging membranes after fetoscopy in congenital diaphragmatic hernia: early cost‐effectiveness analysis

Predicting Perinatal Outcomes in Fetuses with Congenital Diaphragmatic Hernia Using Ultrasound and Magnetic Resonance Imaging

Antenatal management of congenital diaphragmatic hernia: What's next ?

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