Angelika Debus MD, Presenter: Nothing to Disclose

Kristina Kilian, Abstract Co-Author: Nothing to Disclose

Karen Büsing MD, Abstract Co-Author: Nothing to Disclose

Thomas Schaible, Abstract Co-Author: Nothing to Disclose

Stefan Oswald Schoenberg MD, PhD, Abstract Co-Author: Nothing to Disclose

Wolfgang Neff MD, PhD, Abstract Co-Author: Nothing to Disclose

Matched-pair analysis to evaluate the impact of liver herniation as an independent prenatal prognostic factor of mortality and the need for extracorporeal membrane oxygenation (ECMO) therapy in children with CDH.  

Out of a database including 206 fetuses with CDH who underwent fetal MRI a ‘matched-pair´ analysis was performed including fetuses with similar prognostic factors except for liver herniation. Two sets of 36 (n=72) matched pairs were sampled for the same observed to expected fetal lung volume (o/e FLV) (within 1%), same birth weight (within 300 g), same gestational age (within 1 week), and side of herniation. The only difference was herniation (group 1) or no herniation (group 2) of the liver.  

Mortality among children with and without liver herniation is statistically significant different with a 78% survival in children with liver herniation and a 100% survival in the group without liver herniation (p <0.001). Additionally, in children with liver herniation, the need for ECMO therapy reaches 42% in contrast to a 17% need for ECMO therapy in neonates with no liver herniation (p <0.001).  

Children with CDH and liver herniation demonstrate a poorer clinical outcome compared to a matched-pair group of children without liver herniation. Thus, liver herniation can be considered as an independent prognostic factor for mortality and need for ECMO therapy in children with CDH.  

In fetuses with CDH accurate prognostic parameters allow for precise decisions on therapeutic management, e.g. delivery at a specialized tertiary center, and may therefore improve clinical outco

Debus, A, Kilian, K, Büsing, K, Schaible, T, Schoenberg, S, Neff, W, Liver Herniation as an Independent Prognostic Factor in Fetuses with Congenital Diaphragmatic Hernia (CDH): A ‘Matched Pair´ Analysis.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012028.html