Title

Predicting neonatal outcomes in infants with giant omphalocele using prenatal magnetic resonance imaging calculated observed-to-expected fetal lung volumes.

Authors

Enrico Danzer, Children's Hospital of Philadelphia, Philadelphia, PAFollow
J Christopher Edgar, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Elizabeth Eppley, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Matthew A Goldshore, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Etze Chotzoglou, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Lisa M Herkert, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Edward R Oliver, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Natalie E Rintoul, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Howard Panitch, Children's Hospital of Philadelphia, Philadelphia, PAFollow
N Scott Adzick, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Holly L Hedrick, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Teresa Victoria

Publication Title

Prenatal diagnosis

Document Type

Article

PubMed ID

34473853

Abstract

OBJECTIVE: To examine the association between prenatal magnetic resonance imaging (MRI) based observed/expected total lung volume (O/E TLV) and outcome in neonates with giant omphalocele (GO).

METHODS: Between 06/2004 and 12/2019, 67 cases with isolated GO underwent prenatal and postnatal care at our institution. MRI-based O/E TLVs were calculated based on normative data from Meyers and from Rypens and correlated with postnatal survival and morbidities. O/E TLV scores were grouped based on severity into50% (mild) for risk stratification.

RESULTS: O/E TLV was calculated for all patients according to Meyers nomograms and for 49 patients according to Rypens nomograms. Survival for GO neonates with severe, moderate, and mild pulmonary hypoplasia based on Meyers O/E TLV categories was 60%, 92%, and 96%, respectively (p = 0.04). There was a significant inverse association between Meyers O/E TLV and risk of neonatal morbidities (p < 0.05). A similar trend was observed with Rypens O/E TLV, but associations were less often significant likely related to the smaller sample size.

CONCLUSION: Neonatal outcomes are related to fetal lung size in isolated GO. Assessment of Meyers O/E TLV allows identification of GO fetuses at greatest risk for complications secondary to pulmonary hypoplasia.

Keywords

Female, Fetus, Gestational Age, Hernia, Umbilical, Humans, Infant, Newborn, Lung, Lung Volume Measurements, Magnetic Resonance Imaging, Nomograms, Noninvasive Prenatal Testing, Pregnancy, Pregnancy Outcome, Retrospective Studies

DOI

10.1002/pd.6040

Publication Date

10-1-2021

Citation

Danzer, E., Edgar, J., Eppley, E., Goldshore, M., Chotzoglou, E., Herkert, L., Oliver, E., Rintoul, N., Panitch, H., Adzick, N., Hedrick, H., & Victoria, T. (2021). Predicting neonatal outcomes in infants with giant omphalocele using prenatal magnetic resonance imaging calculated observed-to-expected fetal lung volumes.. Prenatal diagnosis, 41 (11), 1439-1448. https://doi.org/10.1002/pd.6040