Fetal lung volume after endoscopic tracheal occlusion in the prediction of postnatal outcome.

Abstract

The objective of the study was to investigate the volume response of the contralateral lung in the prediction of postnatal outcome in fetuses with congenital diaphragmatic hernia (CDH) treated by fetoscopic endotracheal occlusion (FETO). In 30 fetuses with isolated severe CDH that underwent FETO, the volume of the contralateral lung was measured by 3-dimensional ultrasound the day before and 2 and 7 days after FETO. The measurements of fetuses that subsequently died were compared to those who survived. In all fetuses before FETO, the lung volume was below the 2.5th percentile of the normal range for gestation (60%). Within 2 days after FETO, the lung volume increased to above the 2.5th percentile in 14/21 (66%) that survived, compared with 1/9 (11%) that died. The respective percentages at 7 days after FETO were 95% and 11%, respectively. In fetuses with CDH, the lung responsiveness within 2 and 7 days after FETO provides useful prediction of subsequent survival.