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先天性膈疝新生儿升主动脉产前直径较小与死亡风险增加相关。

Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia.

作者信息

Krekora Michał, Sokołowski Łukasz, Murlewska Julia, Zych-Krekora Katarzyna, Słodki Maciej, Grzesiak Mariusz, Gulczyńska Ewa, Maroszyńska Iwona, Respondek-Liberska Maria

机构信息

Department of Obstetrics and Gynaecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.

Department for Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.

出版信息

Arch Med Sci. 2022 Apr 4;19(4):1022-1027. doi: 10.5114/aoms/147768. eCollection 2023.

DOI:10.5114/aoms/147768
PMID:37560725
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10408014/
Abstract

INTRODUCTION

The aim of this study was to evaluate whether selected prenatal markers obtained 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 ( = 21) and the subset of patients who died before discharge from hospital ( = 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 (-test, = 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 (-test, = 0.017). In survivors, the LHR was 1.81 ±0.96 vs. 0.95 ±0.6 in patients who died (-test, = 0.019). In survivors, the observed to expected LHR was 57 ±30% vs 30 ±18% in patients who died (-test, = 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.

摘要

引言

本研究的目的是评估从胎儿超声心动图获得的选定产前标志物是否能够预测先天性膈疝（CDH）患者的产后结局。我们还旨在验证肺头比（LHR）的预后价值。

材料与方法

研究组包括29例患有CDH的胎儿。我们分析了使用胎儿超声心动图和胎儿超声测量的潜在预后参数。比较了存活至出院的CDH患者组（n = 21）和在出院前死亡的患者亚组（n = 8）之间的评估参数。

结果

在幸存者中，升主动脉（AAo）直径的平均z评分为0.23±0.98，而死亡患者为-1.82±1.04（t检验，P = 0.0015）。在幸存者中，主肺动脉/升主动脉比值为1.22±0.17，而死亡患者为1.46±0.21（t检验，P = 0.017）。在幸存者中，LHR为1.81±0.96，而死亡患者为0.95±0.6（t检验，P = 0.019）。在幸存者中，观察到的与预期的LHR为57±30%，而死亡患者为30±18%（t检验，P = 0.018）。

结论

CDH胎儿升主动脉变窄是与新生儿死亡率增加相关的不良预后因素。我们的研究还证实了LHR的预后价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2399/10408014/9243606933ee/AMS-19-4-147768-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2399/10408014/dcae4463c5b7/AMS-19-4-147768-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2399/10408014/46529fa40319/AMS-19-4-147768-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2399/10408014/7f134e23c091/AMS-19-4-147768-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2399/10408014/9243606933ee/AMS-19-4-147768-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2399/10408014/dcae4463c5b7/AMS-19-4-147768-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2399/10408014/46529fa40319/AMS-19-4-147768-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2399/10408014/7f134e23c091/AMS-19-4-147768-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2399/10408014/9243606933ee/AMS-19-4-147768-g004.jpg

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