Prenatal assessment of congenital diaphragmatic hernia at north american fetal therapy network centers: A continued plea for standardization.
Prenat Diagn
; 41(2): 200-206, 2021 01.
Article
em En
| MEDLINE
| ID: mdl-33125174
ABSTRACT
INTRODUCTION:
Prenatal work-up for congenital diaphragmatic hernia (CDH) is important for risk stratification, standardization, counseling, and optimal therapeutic choice. To determine current practice patterns regarding prenatal CDH work-up, including prenatal ultrasound and magnetic resonance imaging (MRI) use, and to identify areas for standardization of such evaluation between fetal centers.METHODS:
A survey regarding prenatal CDH work-up was sent to each member center of the North American Fetal Therapy Network (NAFTNet) (n = 36).RESULTS:
All responded. Sonographic measurement of lung-to-head ratio (LHR) was determined by all, 89% (32/36) of which routinely calculate observed-to-expected LHR. The method for measuring LHR varied 58% (21/36) used a "trace" method, 25% (9/36) used "longest axis," and 17% (6/36) used an "antero-posterior" method. Fetal MRI was routinely used in 78% (28/36) of centers, but there was significant variability in fetal lung volume measurement. Whereas all generated a total fetal lung volume, the planes, methodology and references values varied significantly. All evaluated liver position, 71% (20/28) evaluated stomach position and 54% (15/28) quantified the degree of liver herniation. More consistency in workup was seen between centers offering fetal intervention.CONCLUSION:
Prenatal CDH work-up and management differs considerably among North American fetal diagnostic centers, highlighting a need for its standardization.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cuidado Pré-Natal
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Padrões de Prática Médica
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Imageamento por Ressonância Magnética
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Ultrassonografia Pré-Natal
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Hérnias Diafragmáticas Congênitas
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Fígado
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Pulmão
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
Limite:
Female
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Humans
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Pregnancy
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article