Link: http://www.ncbi.nlm.nih.gov/pubmed/27486655

Fetal Diagn Ther. 2016 Aug 4. [Epub ahead of print]
Fetoscopic Endoluminal Tracheal Occlusion in Fetuses with Severe Diaphragmatic Hernia: A Three-Year Single-Center Experience.
Persico N1, Fabietti I, Ciralli F, Gentilino V, D'Ambrosi F, Boito S, Ossola MW, Colnaghi M, Condò V, Macchini F, Leva E, Mosca F, Fedele L.
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Abstract
OBJECTIVE:
To report on our experience in the prenatal treatment of severe congenital diaphragmatic hernia (CDH) by fetoscopic endoluminal tracheal occlusion (FETO).
METHODS:
Between 2012 and 2014, FETO was performed at our center in 21 cases of CDH considered to be severe based on sonographic measurement of observed/expected lung-to-head ratio (O/E LHR) and side of the defect. We reported pre- and postoperative ultrasound findings, procedure-related complications, pregnancy outcome and survival at 1-3 years of age.
RESULTS:
The median gestational age (GA) at balloon insertion was 28.1 weeks (range 26.0-31.1) and the median GA at delivery 34.7 weeks (range 31.6-39.0); delivery before 32 and 34 weeks occurred in 2 (9.5%) and 7 (33.3%) cases, respectively. Postnatal survival at 1-3 years of age in the 17 cases with isolated unilateral CDH was 47.1%. The percentage difference between pre-balloon removal O/E LHR and pre-FETO O/E LHR was significantly higher in survivors compared to neonates who died (40.8 vs. 21.2%, respectively; p < 0.05).
CONCLUSIONS:
In this study, FETO was associated with an infant survival of 47% in cases with isolated unilateral severe CDH. The post-FETO increase in O/E LHR was higher in fetuses that survived compared to those who died.
© 2016 S. Karger AG, Basel.
PMID: 27486655 DOI: 10.1159/000448096