318 results match your criteria fetuses left-sided


Hypoplastic Left Heart: Stage-I Will be Performed Interventionally, Soon.

Pediatr Cardiol 2021 Apr 19. Epub 2021 Apr 19.

Pediatric Heart Center, Justus-Liebig University, Feulgenstrasse 12, 35385, Giessen, Germany.

The hypoplasia of left-sided heart structures shows great variability and complexity. What the many variants have in common is that their heart structures are neither fully developed before nor after birth. Fetuses and newborns require an individual therapy depending on anatomy and function of the heart. Read More

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Reproducibility of Lung and Liver Volume Measurements on Fetal Magnetic Resonance Imaging in Left-Sided Congenital Diaphragmatic Hernia.

Fetal Diagn Ther 2021 23;48(4):258-264. Epub 2021 Mar 23.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA,

Introduction: Congenital diaphragmatic hernia (CDH) affects 1 in 3,000 live births and is associated with significant morbidity and mortality.

Methods: A review of fetal magnetic resonance imaging (MRI) examinations was performed for fetuses with left CDH and normal lung controls. Image review and manual tracings were performed by 4 pediatric radiologists; right and left lung volumes in the coronal and axial planes as well as liver volume above and below the diaphragm in the coronal plane were measured. Read More

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Prenatal Imaging Diagnosis of Suprarenal Lesions.

Fetal Diagn Ther 2021 17;48(3):235-242. Epub 2021 Mar 17.

Department of Surgery, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA,

Introduction: Prenatal suprarenal lesions represent diverse pathologies. This study investigated prenatal imaging features and regression patterns associated with specific lesion diagnoses.

Methods: This is a multicenter retrospective review of fetuses with prenatally diagnosed suprarenal lesions between 2001 and 2019. Read More

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Embolization of dural arteriovenous fistula during twin pregnancy - A case report and literature review.

Interv Neuroradiol 2021 Jan 28:1591019921991396. Epub 2021 Jan 28.

Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

Background: Several literature reviews have suggested that pregnancy may trigger the formation of dural arteriovenous fistulae (DAVF). However, few case reports have described DAVF discovered during pregnancy, and treatment strategies remain largely unknown. A 28-year-old primigravid woman without any medical history of note presented to our hospital for natural twin conception. Read More

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January 2021

Evidence that FGFRL1 contributes to congenital diaphragmatic hernia development in humans.

Am J Med Genet A 2021 03 14;185(3):836-840. Epub 2021 Jan 14.

Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.

Fibroblast growth factor receptor-like 1 (FGFRL1) encodes a transmembrane protein that is related to fibroblast growth factor receptors but lacks an intercellular tyrosine kinase domain. in vitro studies suggest that FGFRL1 inhibits cell proliferation and promotes cell differentiation and cell adhesion. Mice that lack FGFRL1 die shortly after birth from respiratory distress and have abnormally thin diaphragms whose muscular hypoplasia allows the liver to protrude into the thoracic cavity. Read More

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Accuracy of estimated fetal weight assessment in fetuses with congenital diaphragmatic hernia.

Am J Obstet Gynecol MFM 2020 02 9;2(1):100064. Epub 2019 Nov 9.

Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN.

Background: Congenital diaphragmatic hernia is a congenital anomaly in which fetal abdominal organs herniate into the thoracic cavity through a diaphragmatic defect, which can impede fetal lung development. Standard formulas for estimated fetal weight include measurement of fetal abdominal circumference, which may be inaccurate in fetuses with congenital diaphragmatic hernia because of displacement of abdominal contents into the thorax.

Objectives: This study aimed to assess the accuracy of standard estimated fetal weight assessment in fetuses with congenital diaphragmatic hernia by comparing prenatal assessment of fetal weight with actual birthweight. Read More

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February 2020

Fetal Cerebral Oxygenation Is Impaired in Congenital Heart Disease and Shows Variable Response to Maternal Hyperoxia.

J Am Heart Assoc 2021 Jan 21;10(1):e018777. Epub 2020 Dec 21.

Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco CA.

Background Impairments in fetal oxygen delivery have been implicated in brain dysmaturation seen in congenital heart disease (CHD), suggesting a role for in utero transplacental oxygen therapy. We applied a novel imaging tool to quantify fetal cerebral oxygenation by measuring T2* decay. We compared T2* in fetuses with CHD with controls with a focus on cardiovascular physiologies (transposition or left-sided obstruction) and described the effect of brief administration of maternal hyperoxia on T2* decay. Read More

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January 2021

Sequential Minimally Invasive Fetal Interventions for Two Life-Threatening Conditions: A Novel Approach.

Fetal Diagn Ther 2021 20;48(1):70-77. Epub 2020 Oct 20.

Division of Pediatric Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.

Introduction: In utero interventions are performed in fetuses with "isolated" major congenital anomalies to improve neonatal outcomes and quality of life. Sequential in utero interventions to treat 2 anomalies in 1 fetus have not yet been described.

Case Presentation: Here, we report a fetus with a large left-sided intralobar bronchopulmonary sequestration (BPS) causing mediastinal shift, a small extralobar BPS, and concomitant severe left-sided congenital diaphragmatic hernia (CDH). Read More

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October 2020

The TOTAL trial dilemma: A survey among professionals on equipoise regarding fetal therapy for severe congenital diaphragmatic hernia.

Prenat Diagn 2021 Jan 5;41(2):179-189. Epub 2020 Nov 5.

Department of Development and Regeneration cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium.

Objective: Running randomized clinical trials (RCT) in fetal therapy is challenging. This is no different for fetoscopic endoluminal tracheal occlusion (FETO) for severe left-sided Congenital Diaphragmatic Hernia (CDH). We assessed the knowledge, attitude and practice (KAP) of maternal-fetal medicine specialists toward the antenatal management of CDH, and the randomized controlled clinical (RCT) "Tracheal Occlusion To Accelerate Lung growth-trial. Read More

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January 2021

Feasibility and outcomes of fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia: A Japanese experience.

J Obstet Gynaecol Res 2020 Sep 28. Epub 2020 Sep 28.

Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.

Aim: To present the feasibility, safety and outcomes of fetoscopic endoluminal tracheal occlusion (FETO) for the treatment of severe congenital diaphragmatic hernia (CDH).

Methods: This was a single-arm clinical trial of FETO for isolated left-sided CDH with liver herniation and Kitano Grade 3 stomach position (>50% stomach herniation into the right chest). FETO was performed at 27-29 weeks of gestation for cases with observed/expected lung to head ratio (o/e LHR) <25% and at 30-31 weeks for cases with o/e LHR ≥25%. Read More

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September 2020

Prenatal diagnosis of left-sided aortic arch, right descending aorta and right-sided ductus arteriosus associated with anomalous origin of left pulmonary artery from ascending aorta.

Echocardiography 2020 09 10;37(9):1506-1508. Epub 2020 Aug 10.

Beijing Key Laboratory of Maternal-Fetus Medicine in Fetal Heart Disease, Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Left-sided aortic arch (LAA), right descending aorta (rDAo), and right-sided ductus arteriosus (RDA) constitute a rare aortic arch anomaly. Moreover, anomalous origin of the pulmonary artery from the ascending aorta, especially that of the left pulmonary artery, is also a rare anomaly of the pulmonary artery branches. Because of the presence of the ductus arteriosus, prenatal ultrasound is an optimal diagnostic tool for the LAA with rDAo. Read More

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September 2020

Optimal gestational age at delivery for congenital diaphragmatic hernia.

Ultrasound Obstet Gynecol 2020 Jul 1. Epub 2020 Jul 1.

Centre Reference Maladie Rare, Hernie de Coupole Diaphragmatique, Clamart, France.

Objective: To evaluate the neonatal morbidity and mortality of babies with isolated congenital diaphragmatic hernia (CDH) according to gestational age at delivery.

Methods: We conducted a retrospective study in the University Hospitals of Antoine Béclère-Bicêtre and Leuven between January 1, 2010 and December 31, 2018. Isolated left-sided CDH cases were included. Read More

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Prenatal ultrasound diagnosis of duplication gallbladder: a multicenter study.

Arch Gynecol Obstet 2020 08 12;302(2):377-382. Epub 2020 Jun 12.

Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.

Background: Gallbladder duplication is a rare anatomic anomaly characterized by the presence of an accessory gallbladder.

Objective: To appraise the prevalence and significance of prenatal diagnosis of duplication of gallbladder in a multicenter study.

Methods: This was a multicenter case series with literature review. Read More

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Prenatal stomach position predicts gastrointestinal morbidity at 2 years in fetuses with left-sided congenital diaphragmatic hernia.

Ultrasound Obstet Gynecol 2020 May 27. Epub 2020 May 27.

Department of Gynecology and Obstetrics, Antoine Béclère Hospital, Paris-Sud University, Clamart, France.

Objective: The long-term morbidity associated with isolated left-sided congenital diaphragmatic hernia (CDH) has been described previously. However, antenatal criteria impacting gastrointestinal morbidity (GIM) are not yet defined. The objective of this study was to evaluate the effect of fetal stomach position on the risk of GIM at 2 years of age in children with left-sided CDH. Read More

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Management of Intracranial Hemorrhage and Skull Fracture After Blunt Intrauterine Trauma.

World Neurosurg 2020 06 23;138:352-354. Epub 2020 Mar 23.

Department of Neurosurgery, Jacobs School of Medicine at the University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, John R. Oishei Children's Hospital, Buffalo, New York, USA. Electronic address:

Background: Fetal trauma during pregnancy can have a significant impact on the developing brain. Fetal trauma can lead to several intracranial pathologies including hypoxic-ischemic injury, skull fractures, and intracranial hemorrhages. Blunt trauma to a fetus resulting in the need for neurosurgical intervention is a rare occurrence and seldom described in the literature. Read More

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Fetal cerebrovascular response to maternal hyperoxygenation in congenital heart disease: effect of cardiac physiology.

Ultrasound Obstet Gynecol 2021 May 13;57(5):769-775. Epub 2021 Apr 13.

Division of Pediatric Cardiology, Department of Pediatrics, The University of California San Francisco, San Francisco, CA, USA.

Objective: Fetal cerebrovascular resistance is influenced by several factors in the setting of intact autoregulation to allow for normal cerebral blood flow and oxygenation. Maternal hyperoxygenation (MH) allows for acute alterations in fetal physiology and can be a tool to test cerebrovascular reactivity in late-gestation fetuses. In this study, we utilized MH to evaluate cerebrovascular reactivity in fetuses with specific congenital heart disease (CHD). Read More

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Pulmonary venous Doppler patterns and midterm outcomes in fetuses with left-sided obstructive lesions and restrictive atrial septum.

Prenat Diagn 2020 06 2;40(7):776-784. Epub 2020 Apr 2.

The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Objective: To compare length of stay of the initial neonatal hospitalization and mortality across multiple stages of surgical palliation for infants with left-sided obstructive lesions and severely restrictive or intact atrial septum (I/RAS).

Methods: Retrospective cohort study of patients prenatally diagnosed with left-sided obstructive lesions and I/RAS, defined by fetal pulmonary venous Dopplers.

Results: We identified 76 fetal patients with 59 live born intending to pursue intervention. Read More

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Survival outcome in severe left-sided congenital diaphragmatic hernia with and without fetal endoscopic tracheal occlusion in a country with suboptimal neonatal management.

Ultrasound Obstet Gynecol 2020 Oct 30;56(4):516-521. Epub 2020 Aug 30.

Departments of Neonatal and Pediatric Surgery, Hospital Infantil de Mexico 'Dr. Federico Gómez', Mexico City, Mexico.

Objective: To evaluate the impact of fetal endoscopic tracheal occlusion (FETO) on improving survival of fetuses with severe left-sided congenital diaphragmatic hernia (CDH), as compared with contemporaneous cases managed expectantly during pregnancy, in a country with suboptimal neonatal management.

Methods: In this prospective cohort study, consecutive fetuses with isolated left-sided CDH, normal karyotype and severe pulmonary hypoplasia (defined as liver herniation and observed/expected lung-to-head circumference ratio below 26%) were selected for FETO at less than 32 weeks of gestation in a single tertiary referral center in Queretaro, Mexico. Postnatal outcome (survival up to 28 days after birth) was compared between fetuses treated with FETO and contemporaneous cases with similar lung size managed expectantly during pregnancy. Read More

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October 2020

Fetal cerebrovascular impedance is reduced in left congenital diaphragmatic hernia.

Ultrasound Obstet Gynecol 2021 Mar;57(3):386-391

Division of Pediatric Cardiology, Department of Pediatrics, The University of California San Francisco, San Francisco, CA, USA.

Objectives: Congenital diaphragmatic hernia (CDH) can cause a significant mass effect in the fetal thorax, displacing the heart into the opposite hemithorax. In left-sided CDH (L-CDH), this is associated with smaller left-sided cardiac structures and reduced left-ventricular cardiac output (LVCO). The effect of these physiologic changes on cerebral blood flow is not well understood. Read More

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Imaging modalities and management of prenatally diagnosed suprarenal masses: an updated literature review and the experience at a high volume Fetal Treatment Center.

J Matern Fetal Neonatal Med 2020 Jan 26:1-8. Epub 2020 Jan 26.

Department of Surgery, University of California, San Francisco, CA, USA.

The differential diagnosis for prenatal suprarenal masses (SRMs) is broad and includes neuroblastoma, adrenal hemorrhage, and subdiaphragmatic extralobar pulmonary sequestration (SEPS). We sought to elucidate the appropriate postnatal management for fetuses found to have an SRM. We conducted a retrospective review of patients prenatally diagnosed with SRM at our institution between 1998 and 2018. Read More

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January 2020

Comparison of mediastinal shift angles obtained with ultrasound and magnetic resonance imaging in fetuses with isolated left sided congenital diaphragmatic hernia.

J Matern Fetal Neonatal Med 2020 Jan 23:1-6. Epub 2020 Jan 23.

Department of Medical and Surgical Neonatology, Fetal Medicine and Surgery Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

To compare ultrasound (US) and magnetic resonance imaging (MRI) in the assessment of mediastinal shift angles (MSAs) in fetuses affected by isolated left congenital diaphragmatic hernia (CDH). The use of MRI-MSA and US-MSA as prognostic factor for postnatal survival in fetal left CDH was also explored. This was an observational study of 29 fetuses with prenatally diagnosed isolated left CDH, assessed with both US and MRI examinations between January 2015 and December 2018. Read More

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January 2020

In fetuses with congenital lung masses, decreased ventricular and atrioventricular valve dimensions are associated with lesion size and clinical outcome.

Prenat Diagn 2020 01 1;40(2):206-215. Epub 2019 Dec 1.

Department of Pediatrics, Division of Cardiology, Stanford University School of Medicine, Palo Alto, CA, USA.

Introduction: The clinical importance of mass effect from congenital lung masses on the fetal heart is unknown. We aimed to report cardiac measurements in fetuses with congenital lung masses and to correlate lung mass severity/size with cardiac dimensions and clinical outcomes.

Methods: Cases were identified from our institutional database between 2009 and 2016. Read More

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January 2020

Improvement of cardiac function in fetuses with growth restriction following antenatal betamethasone administration: fact or artifact?

J Matern Fetal Neonatal Med 2019 Nov 11:1-7. Epub 2019 Nov 11.

Neonatology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, India.

Use of corticosteroids for fetal lung maturation has reduced the perinatal mortality/morbidity from prematurity related complications. There is a paucity of studies evaluating the effect of steroid administration on the fetal circulation and cardiac function in fetal growth restriction (FGR). The aim of the study was to assess changes in fetal Doppler indices and cardiovascular function in pregnancies complicated with FGR after administration of betamethasone. Read More

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November 2019

Contribution of single-gene defects to congenital cardiac left-sided lesions in the prenatal setting.

Ultrasound Obstet Gynecol 2020 Aug;56(2):225-232

Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Objectives: To explore the contribution of single-gene defects to the genetic cause of cardiac left-sided lesions (LSLs), and to evaluate the incremental diagnostic yield of whole-exome sequencing (WES) for single-gene defects in fetuses with LSLs without aneuploidy or a pathogenic copy-number variant (pCNV).

Methods: Between 10 April 2015 and 30 October 2018, we recruited 80 pregnant women diagnosed with a LSL who had termination of pregnancy and genetic testing. Eligible LSLs were aortic valve atresia or stenosis, coarctation of the aorta, mitral atresia or stenosis and hypoplastic left heart syndrome (HLHS). Read More

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Neonatal outcome of cases with isolated prenatal ventricular disproportion with a dominant right ventricle.

Prenat Diagn 2019 12 24;39(13):1198-1203. Epub 2019 Oct 24.

Department of Pediatric Cardiology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Objectives: Isolated prenatal ventricular disproportion with a dominant right ventricle represents a challenge in decision-making for both physicians and pregnant women. In the current study, we sought to delineate the postnatal outcomes of these cases.

Methods: This retrospective analysis included consecutive cases of isolated ventricular disproportion identified using complete fetal echocardiography at the Fetal Heart Center of Xinhua Hospital from January 2014 to October 2017. Read More

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December 2019

The assessment of cardiac function with tissue Doppler imaging in fetuses with congenital diaphragmatic hernia.

J Matern Fetal Neonatal Med 2020 Apr 6;33(7):1233-1238. Epub 2019 Oct 6.

Department of Maternal Fetal Medicine, Akdeniz University, Antalya, Turkey.

This study aimed to evaluate the cardiac function of fetuses with congenital diaphragmatic hernia by conventional echocardiography and spectral tissue Doppler imaging (s-TDI) and to evaluate the relationship between cardiac function and the severity of pulmonary hypoplasia. We also aimed to investigate the effect of diaphragmatic hernia side on fetal cardiac function. Fetal cardiac function were evaluated in 28 fetuses (20 with left-sided and 8 with right-sided) complicated with isolated congenital diaphragmatic hernia (CDH) and 56 gestational age matched control in this single center prospective study. Read More

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Prenatal Imaging Features and Postnatal Factors Associated with Gastrointestinal Morbidity in Congenital Diaphragmatic Hernia.

Fetal Diagn Ther 2020 21;47(4):252-260. Epub 2019 Aug 21.

Texas Children's Fetal Center, Texas Children's Hospital and the Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA,

Background: To perform a comprehensive assessment of postnatal gastrointestinal (GI) morbidity and determine the prenatal imaging features and postnatal factors associated with its development in patients with congenital diaphragmatic hernia (CDH).

Materials And Methods: A retrospective review was conducted of all infants evaluated for CDH at a quaternary fetal center from February 2004 to May 2017. Prenatal imaging features and postnatal variables were analyzed. Read More

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January 2021

Splenic Artery Aneurysm (SAA) Rupture in Pregnancy: A Case Report of a Rare but Life-Threatening Obstetrical Complication.

J Womens Health Dev 2019 20;2(1):19-27. Epub 2019 May 20.

Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.

This is the case of a 38 year-old Lebanese woman G2P1, history of previous cesarean section, presenting at 30+5 weeks of gestation with acute left-sided flank pain and a two-day history of chills and dysuria. In light of the clinical presentation, the patient was initially diagnosed with pyelonephritis and managed accordingly; however, her clinical status deteriorated with worsening hypotension and lethargy despite resuscitative measures and a normal abdominal ultrasound. Failure to revive the patient eventually led to a cardiac arrest for which a peri-mortem cesarean section was performed at bedside. Read More

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Fetal Echocardiographic Parameters and Surgical Outcomes in Congenital Left-Sided Cardiac Lesions.

Pediatr Cardiol 2019 Aug 23;40(6):1304-1313. Epub 2019 Jul 23.

Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road, Suite 305, Palo Alto, CA, 94304, USA.

This study aimed to evaluate fetal echocardiographic parameters associated with neonatal intervention and single-ventricle palliation (SVP) in fetuses with suspected left-sided cardiac lesions. Initial fetal echocardiograms (1/2002-1/2017) were interpreted by the contemporary fetal cardiologist as coarctation of the aorta (COA), left heart hypoplasia (LHH), hypoplastic left heart syndrome (HLHS), mitral valve hypoplasia (MVH) ± stenosis, and aortic valve hypoplasia ± stenosis (AS). The cohort comprised 68 fetuses with suspected left-sided cardiac lesions (COA n = 15, LHH n = 9, HLHS n = 39, MVH n = 1, and AS n = 4). Read More

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Standardization and reproducibility of sonographic stomach position grades in fetuses with congenital diaphragmatic hernia.

J Clin Ultrasound 2019 Nov 16;47(9):513-517. Epub 2019 Jul 16.

Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota, United States.

Objectives: The purpose of this study was to evaluate the reproducibility of stomach position grading in congenital diaphragmatic hernia (CDH) as proposed by Cordier et al and Basta et al after standardization of the methods at our center.

Methods: We collected sonographic images from 23 fetuses with left-sided CDH at our center from 2010 to 2018. Nine operators (one maternal fetal medicine expert and eight sonographers) reviewed the selected images and graded the stomach position according to the methods of Cordier et al and Basta et al. Read More

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November 2019