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Vol. 31, No. 4, 2012
Issue release date: June 2012
Section title: Original Paper
Fetal Diagn Ther 2012;31:248–253
(DOI:10.1159/000334284)

Fetal MRI-Calculated Total Lung Volumes in the Prediction of Short-Term Outcome in Giant Omphalocele: Preliminary Findings

Danzer E. · Victoria T. · Bebbington M.W. · Siegle J. · Rintoul N.E. · Johnson M.P. · Flake A.W. · Adzick N.S. · Hedrick H.L.
The Center for Fetal Diagnosis and Treatment, The Children’s Hospital of Philadelphia and The University of Pennsylvania School of Medicine, Philadelphia, Pa., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/6/2011 11:07:14 AM
Accepted: 9/26/2011
Published online: 4/27/2012

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 1

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT

Abstract

Objective: To determine the value of fetal MRI-calculated total lung volumes (TLV) in the prediction of short-term outcome in patients with giant omphalocele (GO). Material and Methods: We reviewed all cases of GO undergoing fetal MRI after 21 weeks’ gestation and receiving postnatal care at our institution between 2003 and 2010. Observed/expected (O/E) TLV was calculated using age-matched TLV normograms [Radiology 2001;219:236–241]. Postnatal outcomes were stratified based on O/E TLV above or below 50% of expected. Results: Seventeen GO cases fulfilled the entry criteria. The mean age at fetal MRI evaluation was 25.8 ± 4.8 weeks’ gestation. The mean GO TLV (21.0 ± 13.2) was lower than age-matched population norms (p < 0.001), resulting in a mean O/E TLV of 52.3 ± 16.8%. The mean gestational age at delivery was 36.8 ± 1.6 weeks. Overall survival was 94%. Fourteen (88%) infants underwent staged reduction, and 2 underwent silver sulfadiazine treatment and delayed repair. Infants with ≤50% of predicted O/E TLV (n = 11, 65%) had lower Apgar scores at birth (p = 0.03), prolonged ventilatory support (p = 0.004), delayed oral intake (p = 0.03), and longer hospitalization (p = 0.03) compared to patients with ≥50% of expected O/E TLV. Two infants (both O/E TLV <50%) required tracheostomy placement. Conclusion: In the assessment of GO fetuses, MRI-based O/E TLV of <50% was predictive of increased postnatal morbidity.


  

Author Contacts

Holly L. Hedrick, MD
The Center for Fetal Diagnosis and Treatment
5th Floor Wood Center, The Children’s Hospital of Philadelphia
34th Street and Civic Center Boulevard, Philadelphia, PA 19104 (USA)
Tel. +1 215 590 2747, E-Mail hedrick@email.chop.edu

  

Article Information

Received: July 6, 2011
Accepted after revision: September 26, 2011
Published online: April 27, 2012
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 1, Number of References : 28

  

Publication Details

Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)

Vol. 31, No. 4, Year 2012 (Cover Date: June 2012)

Journal Editor: Gratacós E. (Barcelona)
ISSN: 1015-3837 (Print), eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/6/2011 11:07:14 AM
Accepted: 9/26/2011
Published online: 4/27/2012

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 1

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


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