Wang Weipeng,Pan Weihua,Wang Jun.Assessing perinatal prognostic risks for children with congenital diaphragmatic hernia[J].Journal of Clinical Pediatric Surgery,,18():977-983.[doi:10.3969/j.issn.1671—6353.2019.11.016]
Assessing perinatal prognostic risks for children with congenital diaphragmatic hernia
- Keywords:
- Hernia; Diaphragmatic/CN; Perinatal Period; Prognosis; Risk Assessment
- CLC:
- R726.1;R655.6;R730.7
- Abstract:
- Congenital diaphragmatic hernia(CDH)is a congenital disease caused by diaphragmatic muscle defect caused by pause of diaphragmatic muscle during embryonic period and abdominal cavity into chest cavity.The incidence rate is estimated at 1/5 000 to 1/2 000[1].With the continuous improvement of the concept and technology of diagnosis and treatment in recent years,the survival rate of CDH has gradually improved.However,the mortality rate of severe CDH is still as high as 40% to 60%.The major causes of mortality are pulmonary dysplasia and pulmonary hypertension.Therefore early accurate assessments of CDH may aid prenatal consultations and fetal interventions and have important guiding implications for perinatal management,postpartum neonatal diagnosis & treatment,surgical timing and specific surgical approaches.Several commonly used risk assessment models include lung-to-head ratio(LHR),O/E LHR(observed to expected lung area-to-head ratio),liver position,ratio of liver herniating into chest,MRI measurement of total fetal lung volume(TFLV),Apgar score,birth weight,(Score for neonatal acute physiology,version Ⅱ,SNAP-Ⅱ)and simplified version of score for neonatal acute physiology perinatal extension(SNAPPE-Ⅱ)and the size of the diaphragmatic defect,etc.
References:
1 Chandrasekharan PK,Rawat M,Madappa R,et al.Congenital Diaphragmatic hernia:a review[J].Matern Health Neonatol Perinatol,2017,3(1):6.DOI:10.1186/s40748-017-0045-1.
2 Metkus AP,Filly RA,Stringer MD,et al.Sonographic predictors of survival in fetal diaphragmatic hernia[J].J Pediatr Surg,1996,31(1):148-151.DOI:10.1016/S0022-3468(96)90338-3.
3 Heling KS,Wauer RR,Hammer H,et al.Reliability of the lung-to-head ratio in predicting outcome and neonatal ventilation parameters in fetuses with congenital diaphragmatic hernia[J].Ultrasound Obstet Gynecol,2005,25(2):112-118.DOI:10.1002/uog.1837.
4 Yang SH,Nobuhara KK,Keller RL,et al.Reliability of the lung-to-head ratio as a predictor of outcome in fetuses with isolated left congenital diaphragmatic hernia at gestation outside 24-26 weeks[J].Am J Obstet Gynecol,2007,197(1):30.e1-7.DOI:10.1016/j.ajog.2007.01.016.
5 Jani JC,Peralta CFA,Nicolaides KH.Lung-to-head ratio:a need to unify the technique[J].Ultrasound Obstet Gynecol,2012,39(1):2-6.DOI:10.1002/uog.11065.
6 Deprest J,Brady P,Nicolaides K,et al.Prenatal management of the fetus with isolated congenital diaphragmatic hernia in the era of the TOTAL trial[J].Semin Fetal Neonatal Med,2014,19(6):338-348.DOI:10.1016/j.siny.2014.09.006.
7 Snoek KG,Peters NC J,Van Rosmalen J,et al.The validity of the observed toexpected lung-to-head ratio in congenital diaphragmatic hernia in an era of standardized neonatal treatment; a multicenter study[J].Prenat Diagn,2017,37(7):658-665.DOI:10.1002/pd.5062.
8 King SK,Alfaraj M,Gaiteiro R,et al.Congenital diaphragmatic hernia:Observed/expected lung-to-head ratio as a predictor of long-term morbidity[J].J Pediatr Surg,2016,51(5):699-702.DOI:10.1016/j.jpedsurg.2016.02.004.
9 Cruz-Martinez R,Figueras F,Moreno-Alvarez O,et al.Learning curve for lung area to head circumference ratio measurement in fetuses with congenital diaphragmatic hernia[J].Ultrasound Obstet Gynecol,2010,36(1):32-36.DOI:10.1002/uog.7577.
10 Hedrick HL.Management of prenatally diagnosed congenital diaphragmatic hernia[J].Seminars in Fetal & Neonatal Medicine,2013,15(1):21-27.DOI:10.1016/j.siny.2009.07.012.
11 Oluyomi-Obi T,Kuret V,Puligandla P,et al.Antenatal predictors of outcome in prenatally diagnosed congenital diaphragmatic hernia(CDH)[J].J Pediatr Surg,2017,52(5):881-888.DOI:10.1016/j.jpedsurg.2016.12.008.
12 Straňák,Zbyněk,Krofta L,et al.Antenatal assessment of liver position,rather than lung-to-head ratio(LHR)or observed/expected LHR,is predictive of outcome in fetuses with isolated left-sided congenital diaphragmatic hernia[J].J Matern Fetal Neonatal Med,2016:1-5.DOI:10.3109/14767058.2016.1163539.
13 Cannie M,Jani J,Chaffiotte C,et al.Quantification of intrathoracic liver herniation by magnetic resonance imaging and prediction of postnatal survival in fetuses with congenital diaphragmatic hernia[J].Ultrasound Obstet Gynecol,2008,32(5):627-632.DOI:10.1002/uog.6146.
14 Lazar DA,Ruano R,Cass DL,et al.Defining "liver-up":does the volume of liver herniation predict outcome for fetuses with isolated left-sided congenital diaphragmatic hernia?[J].J Pediatr Surg,2012,47(6):1058-1062.DOI:10.1016/j.jpedsurg.2012.03.003.
15 Akinkuotu AC,Cruz SM,Abbas PI,et al.Risk-stratification of severity for infants with CDH:Prenatal versus postnatal predictors of outcome[J].J Pediatr Surg,2016,51(1):44-48.DOI:10.1016/j.jpedsurg.2015.10.009.
16 Werneck Britto IS,Olutoye OO,Cass DL,et al.Quantification of liver herniation in fetuses with isolated congenital diaphragmatic hernia using two-dimensional ultrasonography[J].Ultrasound Obstet Gynecol,2015,46(2):150-154.DOI:10.1002/uog.14718.
17 Lee TC,Lim FY,Keswani SG,et al.Late gestation fetal magnetic resonance imaging-derived total lung volume predicts postnatal survival and need for extracorporeal membrane oxygenation support in isolated congenital diaphragmatic hernia[J].J Pediatr Surg,2011,46(6):1165-1171.DOI:10.1016/j.jpedsurg.2011.03.046.
18 Ruano R,Lazar DA,Cass DL,et al.Fetal lung volume and quantification of liver herniation by magnetic resonance imaging in isolated congenital diaphragmatic hernia[J].Ultrasound Obstet Gynecol,2014,43(6):662-669.DOI:10.1002/uog.13223.
19 原丽科,唐晶,俞钢.产前MRI在评估胎儿膈疝的应用及研究进展[J].临床小儿外科杂志,2016,15(3):292-294.DOI:10.3969/j.issn.1671-6353.2016.03.024. Yuan LK,Tang J,Yu G.Application and research advance of prenatal MRI in evaluating diaphragmatic hernia[J].J Clin Ped Sur,2016,15(3):292-294.DOI:10.3969/j.issn.1671-6353.2016.03.024.
20 Kitano Y,Okuyama H,Saito M,et al.Re-evaluation of stomach position as a simple prognostic factor in fetal left congenital diaphragmatic hernia:a multicenter survey in Japan[J].Ultrasound Obstet Gynecol,2015,37(3):277-282.DOI:10.1002/uog.8892.
21 Cordier AG,Jani JC,Cannie MM,et al.Stomach position in prediction of survival in left-sided congenital diaphragmatic hernia with or without fetoscopic endoluminal tracheal occlusion[J].Ultrasound Obstet Gynecol,2015,46(2):155-161.DOI:10.1002/uog.14759.
22 Basta AM,Lusk LA,Keller RL,et al.Fetal Stomach Position Predicts Neonatal Outcomes in Isolated Left-Sided Congenital Diaphragmatic Hernia[J].Fetal Diagn Ther,2015,39(4):248-255.DOI:10.1159/000440649.
23 Croup TCDHS.Estimating disease severity of congenital diaphragmatic hernia in the first 5 minutes of life[J].J Pediatr Surg,2001,36(1):141-145.DOI:10.1053/jpsu.2001.20032.
24 Baird R,Macnab YC,Skarsgard ED,et al.Mortality prediction in congenital diaphragmatic hernia[J].J Pediatr Surg,2008,43(5):783-787.DOI:10.1016/j.jpedsurg.2007.12.012.
25 Downard CD,Jaksic T,Garza JJ,et al.Analysis of an improved survival rate for congenital diaphragmatic hernia[J].J Pediatr Surg,2003,38(5):729-732.DOI:10.1016/jpsu.2003.50194.
26 Javid PJ,Jaksic T,Skarsgard ED,et al.Survival rate in congenital diaphragmatic hernia:the experience of the Canadian neonatal network[J].J Pediatr Surg,2004,39(5):657-660.DOI:10.1016/j.jpedsurg.2004.01.022.
27 Mclane MA,Gabbeta J,Rao AK,et al.SNAPPE Ⅱ score as a predictor of survival in neonates with congenital diaphragmatic hernia:a single center experience[J].Eur J Pediatr Surg,2016,26(4):316-321.DOI:10.1055/s-0035-1554103.
28 Richardson DK,Corcoran JD,Escobar GJ,et al.SNAP-Ⅱ and SNAPPE-Ⅱ:Simplified newborn illness severity and mortality risk scores[J].J Pediatr,2001,138(1):92-100.DOI:10.1067/mpd.2001.109608.
29 Skarsgard ED,Macnab YC,Qiu Z,et al.SNAP-Ⅱ predicts mortality among infants with congenital diaphragmatic hernia[J].J Perinatol,2005,25(5):315-319.DOI:10.1038/sj.jp.7211257.
30 Haricharan RN,Barnhart DC,Cheng H,et al.Identifying neonates at a very high risk for mortality among children with congenital diaphragmatic hernia managed with extracorporeal membrane oxygenation[J].J Pediatr Surg,2009,44(1):87-93.DOI:10.1016/j.jpedsurg.2008.10.015.
31 Grizelj R,Bojani K,Priti sanac E,et al.Survival prediction of high-risk outborn neonates with congenital diaphragmatic hernia from capillary blood gases[J].BMC Pediatr,2016,16(1):114.DOI:10.1186/s12887-016-0658-y.
32 Salas A,Bhat R,Dabrowska K,et al.The Value of Paco 2 in Relation to Outcome in Congenital Diaphragmatic Hernia[J].Am J Perinatol,2014,31(11):939-946.DOI:10.1055/s-0034-1368088.
33 Gentili A,Giuntoli L,Bacchi Reggiani ML,et al.Neonatal congenital diaphragmatic hernia:respiratory and blood-gas derived indices in choosing surgical timing[J].Minerva Anestesiol,2012,78(10):1117.DOI:10.1016/j.ijoa.2012.07.001.
34 Hoffman SB,Massaro AN,Gingalewski C,et al.Predictors of survival in congenital diaphragmatic hernia patients requiring extracorporeal membrane oxygenation:CNMC 15-year experience[J].J Perinatol,2010,30(8):546-552.DOI:10.1038/jp.2009.193.
35 Schultz CM,Digeronimo RJ,Yoder BA,et al.Congenital diaphragmatic hernia:a simplified postnatal predictor of outcome[J].J Pediatr Surg,2007,42(3):510-516.DOI:10.1016/j.jpedsurg.2006.10.043.
36 Brindle ME,Cook EF,Tibboel D,et al.A clinical prediction rule for the severity of congenital diaphragmatic hernias in newborns[J].Pediatrics,2014,134(2):e413-e419.DOI:10.1542/peds.2013-3367.
37 Group TCDHS,Lally KP,Lally PA,et al.Defect size determines survival in infants with congenital diaphragmatic hernia[J].Pediatrics,2007,120(3):e651-e657.DOI:10.1542/peds.2006-3040.
38 Group TCDHS,Morini F,Valfre L,et al.Congenital diaphragmatic hernia:defect size correlates with developmental defect[J].J Pediatr Surg,2013,48(6):1177-1182.DOI:10.1016/j.jpedsurg.2013.03.011.
39 Putnam LR,Harting MT,Tsao K,et al.Congenital diaphragmatic hernia defect size and infant morbidity at discharge[J].Pediatrics,2016,138(5):e20162043.DOI:10.1542/peds.2016-2043.
40 Kengo H,Takamizawa S,Miyake Y,et al.Preoperative sonographic evaluation of the defect size and the diaphragm rim in congenital diaphragmatic hernia:preliminary experience[J].Pediatr Radiol,2018,48(11):1550-1555.DOI:10.1007/s00247-018-4184-y.
41 Werner NL,Coughlin M,Kunisaki SM,et al.Prenatal and postnatal markers of severity in congenital diaphragmatic hernia have similar prognostic ability[J].Prenat Diagn,2016,36(2):107-111.DOI:10.1002/pd.4721.
Memo
收稿日期:2018-09-12。
基金项目:上海交通大学医学院"紧缺专业硕士研究生临床研究能力提升计划"课题（编号：JQ201708）
通讯作者:王俊,Email:wangjun@xinhuamed.com.cn