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Predicting Neonatal Deaths and Pulmonary Hypoplasia in Isolated Congenital Diaphragmatic Hernia Using the Sonographic Fetal Lung Volume–Body Weight Ratio

Rodrigo Ruano1,2, Marie-Cecile Aubry2, Yves Dumez2, Marcelo Zugaib1 and Alexandra Benachi2

1 Department of Obstetrics, Instituto Central do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Av. Dr. Enéas de Carvalho Aguiar, 225—10o andar—Sala 10.085, São Paulo, Brasil CEP 05403-000.
2 Department of Maternity, Hôpital Necker-Enfants Malades, Université de Paris V, Paris, France.


Figure 1
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  		Fig. 1 —Three-dimensional (rendered) image of right (contralateral) and left (ipsilateral) lungs of fetus with left-sided congenital diaphragmatic hernia at 28 weeks of gestation.

 

Figure 2
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  		Fig. 2 —Graph shows ratio of sonographic fetal lung volume to body weight according to gestational age in 450 healthy control subjects (•) and in fetuses with congenital diaphragmatic hernia that are alive and well ({square}), were terminated ({blacktriangleup}), and died as neonates (x). Mean sonographic fetal lung volume–body weight ratio (solid line) was 0.025; 10th centile (lower dashed line) and 90th centile (upper dashed line) were 0.020 and 0.032, respectively.

 

Figure 3
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  		Fig. 3 —Box plot of sonographic estimated fetal lung volume to body weight ratio in fetuses with congenital diaphragmatic hernia that died and those that lived (p = 0.018). Point inside box corresponds to median values. Upper and lower bars of boxes correspond to first and third quartiles, respectively. Two vertical lines (called whiskers) outside box extend to smallest and largest observations.

 

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