Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R.China.
Beijing Maternal and Child Health Care Hospital, Beijing, P.R.China.
Prenat Diagn. 2023 Jul;43(8):1008-1017. doi: 10.1002/pd.6383. Epub 2023 May 16.
To evaluate the correlation between stomach position (SP) grading and postnatal outcomes in fetuses with isolated left-sided congenital diaphragmatic hernias (CDHs).
A literature search was conducted using the PubMed, Embase, and Cochrane Library databases. The corresponding 95% confidence intervals (CIs) were used to assess the differences in the odds of mortality according to the SP graded as level 0 to level 3. To evaluate the reliability of our results, a sensitivity analysis was also conducted.
Nine papers with a total of 542 fetuses with isolated left-sided CDH were included. Congenital diaphragmatic hernia pregnancies complicated by an intrathoracic stomach had higher odds of neonatal mortality when compared with intraabdominal stomach (odds ratio [OR] 2.86; 95% CI 1.38-5.94). Four papers with SP grading from level 0 to level 3 were included in a subgroup analysis. Stomach position at level 1 and level 2 had lower odds of neonatal mortality when separately compared to level 3 (OR 0.12; 95% CI 0.04-0.33) and (OR 0.30; 95% CI 0.16-0.54). Stomach position at level 1 had lower odds of neonatal mortality when compared with level 2 + 3 (OR 0.25; 95% CI 0.09-0.66).
Survival of fetuses with isolated left-sided CDH is correlated with the SP.
评估孤立性左侧先天性膈疝（CDH）胎儿胃位置（SP）分级与产后结局的相关性。
使用 PubMed、Embase 和 Cochrane 图书馆数据库进行文献检索。使用相应的 95%置信区间（CI）评估 SP 分级为 0 级至 3 级时，死亡率的差异。为了评估我们结果的可靠性，还进行了敏感性分析。
纳入 9 篇共 542 例孤立性左侧 CDH 胎儿的文献。与腹腔内胃相比，胸腔内胃的先天性膈疝妊娠新生儿死亡率更高（比值比 [OR] 2.86；95%CI 1.38-5.94）。4 篇文献进行了 SP 分级 0 级至 3 级的亚组分析。与 3 级相比，1 级和 2 级的胃位置新生儿死亡率较低（OR 0.12；95%CI 0.04-0.33）和（OR 0.30；95%CI 0.16-0.54）。与 2 级+3 级相比，1 级的胃位置新生儿死亡率较低（OR 0.25；95%CI 0.09-0.66）。
孤立性左侧 CDH 胎儿的存活率与 SP 相关。
