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. 2023 Nov;43(12):1514-1519.
doi: 10.1002/pd.6449. Epub 2023 Oct 8.

Fetal lung volumes measured by MRI predict pulmonary morbidity among infants with giant omphaloceles

Lauren T Gallagher  1 , Bailey D Lyttle  1 , Mariana L Meyers  2   3 , Jason Gien  2   4 , Michael V Zaretsky  2   5 , Henry L Galan  2   5 , Nicholas Behrendt  2   5 , Kenneth W Liechty  1   2   6   7 , Sarkis Christopher Derderian  1   2   6
Affiliations

Fetal lung volumes measured by MRI predict pulmonary morbidity among infants with giant omphaloceles

Lauren T Gallagher et al. Prenat Diagn. 2023 Nov.

Abstract

Objective: Giant omphaloceles (GO) have associated pulmonary hypoplasia and respiratory complications. Total lung volumes (TLV) on fetal MRI can prognosticate congenital diaphragmatic hernia outcomes; however, its applicability to GO is unknown. We hypothesize that late gestation TLV and observed-to-expected TLV (O/E TLV) on fetal MRI correlate with postnatal pulmonary morbidity in GO.

Method: A single-institution retrospective review of GO evaluated between 2012 and 2022 was performed. Fetal MRI TLV between 32 and 36 weeks' gestation and O/E TLV throughout gestation were calculated and correlated with postnatal outcomes.

Results: 86 fetuses with omphaloceles were evaluated; however, only 26 met strict inclusion criteria. MRIs occurred between 18 and 36 weeks' gestation. Those requiring delivery room intubation had significantly lower late gestation TLV and O/E TLV. O/E TLV predicted tracheostomy placement and survival. Neither TLV nor O/E TLV predicted the length of hospitalization or supplemental oxygen after discharge. Three fetuses had a TLV less than 35 mL: one died of respiratory failure, and the other two required tracheostomy.

Conclusions: Fetal MRI TLV measured between 32 and 36 weeks' gestation and O/E TLV predict the need for delivery room intubation and tracheostomy. O/E TLV correlated with survival. These data support fetal MRI as a prognostic tool to predict GO associated pulmonary morbidity.

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