What Is Your Diagnosis?

Yıl 2016, Cilt: 13 Sayı: 4, 184 - 185, 01.10.2016

Burcu Artunç-ülkümen Karl Oliver Kağan

Öz

Postnatal mortality and morbidity depends on the associated anomalies, on the position of the liver and on theremaining size of the lungs. With decre- asing volume of the lungs, the number of vessels and bronchioli decreases resulting in a hampered oxygenation and pulmonary hypertension.The chance of survival can be estimated by the lung to head ratio LHR and the respe- ctive observed to expected LHR o/e LHR . To compute the LHR, the area of the contralateral lung is divided by head circumference. In general, the ratio between the observed and expected LHR is used for counseling as this marker is independent from gestational age.In a series of 161 fetuses with isolated left sided CDH and intrathoratic liver herniation, about half of the neonates were discharged from hospital alive. The chance of postnatal survival was 258 × o/e LHR % −28,68 /100. In this registry there were also eight cases with isolated right sided CDH and none of the cases survived after birth. In cases with severe CDH o/e LHR < 25% , fetal endoscopic tracheal occlusion can be offered which may increase the survival rate 5 . References

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Kaynakça

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