Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia
Introduction The aim of this study was to evaluate if selected prenatal markers obtainded from fetal echocardiography can predict postnatal outcome in congenital diaphragmatic hernia (CDH) patients. We also aimed to verify the prognostic value of lung-to-head ratio (LHR). Material and methods The s...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Termedia Publishing House
2022-04-01
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| Series: | Archives of Medical Science |
| Subjects: | |
| Online Access: | https://www.archivesofmedicalscience.com/Small-prenatal-diameter-of-the-ascending-aorta-is-associated-with-increased-mortality,147768,0,2.html |
| _version_ | 1797435483019542528 |
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| author | Michał Krekora Łukasz Sokołowski Julia Murlewska Katarzyna Zych-Krekora Maciej Słodki Mariusz Grzesiak Ewa Gulczyńska Iwona Maroszyńska Maria Respondek-Liberska |
| author_facet | Michał Krekora Łukasz Sokołowski Julia Murlewska Katarzyna Zych-Krekora Maciej Słodki Mariusz Grzesiak Ewa Gulczyńska Iwona Maroszyńska Maria Respondek-Liberska |
| author_sort | Michał Krekora |
| collection | DOAJ |
| description | Introduction
The aim of this study was to evaluate if selected prenatal markers obtainded from fetal echocardiography can predict postnatal outcome in congenital diaphragmatic hernia (CDH) patients. We also aimed to verify the prognostic value of lung-to-head ratio (LHR).
Material and methods
The study group included 29 fetuses with CDH. We analyzed potentially prognostic parameters measured using fetal echocardiography and fetal ultrasound. The assessed parameters were compared between the group of patients with CDH who survived to discharge (n=21) and the subset of patients who died before discharge from hospital (n=8).
Results
In survivors, mean z-score for ascending aorta (AAo) diameter was 0.23 ± 0.98 vs – 1.82 ± 1.04 in patients who died (t-test, p=0.0015).
In survivors, the main pulmonary artery/ascending aorta ratio was 1.22 ± 0.17 vs 1.46 ± 0.21 in patients who died (t-test, p=0.017).
In survivors, the LHR was 1.81 ± 0.96 vs 0.95 ± 0.6 in patients who died (t-test, p=0.019).
In survivors, the observed to expected LHR was 57% ± 30% vs 30% ± 18% in patients who died (t-test, p=0.018).
Conclusions
Narrowing of the ascending aorta in CDH fetuses is a poor prognostic factor associated with increased mortality in neonates. Our study also confirmed the prognostic value of LHR. |
| first_indexed | 2024-03-09T10:47:44Z |
| format | Article |
| id | doaj.art-c570dec43a98417aa48ea72070e2dcc4 |
| institution | Directory Open Access Journal |
| issn | 1734-1922 1896-9151 |
| language | English |
| last_indexed | 2024-03-09T10:47:44Z |
| publishDate | 2022-04-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Archives of Medical Science |
| spelling | doaj.art-c570dec43a98417aa48ea72070e2dcc42023-12-01T09:50:30ZengTermedia Publishing HouseArchives of Medical Science1734-19221896-91512022-04-011941022102710.5114/aoms/147768147768Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic herniaMichał Krekora0https://orcid.org/0000-0002-5496-4556Łukasz Sokołowski1https://orcid.org/0000-0002-0205-7495Julia Murlewska2https://orcid.org/0000-0002-8266-4585Katarzyna Zych-Krekora3https://orcid.org/0000-0003-4305-8328Maciej Słodki4https://orcid.org/0000-0002-0160-8013Mariusz Grzesiak5https://orcid.org/0000-0002-6900-4347Ewa Gulczyńska6https://orcid.org/0000-0003-2713-5258Iwona Maroszyńska7https://orcid.org/0000-0003-4061-4843Maria Respondek-Liberska8https://orcid.org/0000-0003-0238-2172Department of Obstetrics and Gynaecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, PolandDepartment of Obstetrics and Gynaecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, PolandDepartment for Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, PolandDepartment of Obstetrics, Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, PolandDepartment for Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, PolandDepartment of Obstetrics, Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, PolandDepartment of Neonatology, Polish Mother’s Memorial Hospital Research Institute, Lodz, PolandDepartment of Intensive Care and Congenital Malformations of Newborns and Infants, Polish Mother’s Memorial Hospital Research Institute, Lodz, PolandDepartment for Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, PolandIntroduction The aim of this study was to evaluate if selected prenatal markers obtainded from fetal echocardiography can predict postnatal outcome in congenital diaphragmatic hernia (CDH) patients. We also aimed to verify the prognostic value of lung-to-head ratio (LHR). Material and methods The study group included 29 fetuses with CDH. We analyzed potentially prognostic parameters measured using fetal echocardiography and fetal ultrasound. The assessed parameters were compared between the group of patients with CDH who survived to discharge (n=21) and the subset of patients who died before discharge from hospital (n=8). Results In survivors, mean z-score for ascending aorta (AAo) diameter was 0.23 ± 0.98 vs – 1.82 ± 1.04 in patients who died (t-test, p=0.0015). In survivors, the main pulmonary artery/ascending aorta ratio was 1.22 ± 0.17 vs 1.46 ± 0.21 in patients who died (t-test, p=0.017). In survivors, the LHR was 1.81 ± 0.96 vs 0.95 ± 0.6 in patients who died (t-test, p=0.019). In survivors, the observed to expected LHR was 57% ± 30% vs 30% ± 18% in patients who died (t-test, p=0.018). Conclusions Narrowing of the ascending aorta in CDH fetuses is a poor prognostic factor associated with increased mortality in neonates. Our study also confirmed the prognostic value of LHR.https://www.archivesofmedicalscience.com/Small-prenatal-diameter-of-the-ascending-aorta-is-associated-with-increased-mortality,147768,0,2.htmlrisk factorultrasoundprenatal diagnosisfetusfetal echocardiographycongenital diaphragmatic herniaaortafetal heart |
| spellingShingle | Michał Krekora Łukasz Sokołowski Julia Murlewska Katarzyna Zych-Krekora Maciej Słodki Mariusz Grzesiak Ewa Gulczyńska Iwona Maroszyńska Maria Respondek-Liberska Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia Archives of Medical Science risk factor ultrasound prenatal diagnosis fetus fetal echocardiography congenital diaphragmatic hernia aorta fetal heart |
| title | Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia |
| title_full | Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia |
| title_fullStr | Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia |
| title_full_unstemmed | Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia |
| title_short | Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia |
| title_sort | small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia |
| topic | risk factor ultrasound prenatal diagnosis fetus fetal echocardiography congenital diaphragmatic hernia aorta fetal heart |
| url | https://www.archivesofmedicalscience.com/Small-prenatal-diameter-of-the-ascending-aorta-is-associated-with-increased-mortality,147768,0,2.html |
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