Congenital diaphragmatic hernia: 2D lung area and 3D lung volume measurements of the contralateral lung to predict postnatal outcome.

OBJECTIVES: The aim of the study was to evaluate the prognostic utility of 2D lung area and 3D lung volume measurements of the contralateral lung in infants with congenital diaphragmatic hernia. METHODS: At 18-37 weeks' gestation between 1 and 5 scans of the contralateral fetal lung were obtained in 6 pregnancies complicated by congenital diaphragmatic hernia (5 left- and 1 right-sided). Lung volume measurements were compared with reference curves for gestational age and estimated fetal weight obtained from uncomplicated pregnancies. Lung area measurements were compared with reference nomograms. RESULTS: Three infants survived and 3 died. Lung volume measurements versus gestational age were beneath the 5th percentile for the nonsurviving infants and within the normal ranges for the surviving infants. When comparing the observed/expected lung volume and lung area ratios of the first measurements with the ratios at the last visit before birth, the ratios of the infants who subsequently died decreased whereas the ratios of the infants who survived remained unchanged or increased. CONCLUSIONS: In the case of congenital diaphragmatic hernia, 3D lung volume measurements seem to be a good predictor of outcome but longitudinal measurement also provides important additional information. Larger studies are necessary to confirm these results.