TY - JOUR
T1 - Prenatal assessment of congenital diaphragmatic hernia at north american fetal therapy network centers
T2 - A continued plea for standardization
AU - North American Fetal Therapy Network (NAFTNet)
AU - Perrone, Erin E.
AU - Abbasi, Nimrah
AU - Cortes, Magdalena Sanz
AU - Umar, Uzma
AU - Ryan, Greg
AU - Johnson, Anthony
AU - Ladino-Torres, Maria
AU - Ruano, Rodrigo
N1 - Funding Information:
The authors would like to thank those that responded to the survey and have included a list below in alphabetical order, excluding those who requested anonymity: Mert Ozan Bahtiyar, MD, Yale School of Medicine; Richard Brown, MD, McGill University Health Center; Terry L. Buchmiller, MD, Boston Children's Hospital; Darrell Cass, MD, Cleveland Clinic Fetal Center; Elisabeth Codsi, MD, University of Montreal; Amy Mehollin-Ray, MD, Baylor College of Medicine; Timothy M. Crombleholme, MD, Medical City Children's Hospital; Sarah Davis, MD, Fetal Treatment Program of New England; Kathryn J. Drennan, MD, University of Rochester; Katie Francis, APRN, SSM Health Cardinal Glennon Children's Hospital; Alain Gagnon, MD, University of British Columbia; William Goodnight, MD, University of North Carolina School of Medicine; Holly Hedrick, MD, Children's Hospital of Philadelphia; Dilkash Kajal, MD, University Health Network and University of Toronto; Maria Ladino-Torres, MD, University of Michigan; Burhan Mahmood, MD, Children's Hospital of Pittsburg; Rony Marwan, MD, Colorado Fetal Care Center; Suwan Mehra, MD, Advocate Children's Hospital; Jena Miller, MD, Johns Hopkins Center for Fetal Therapy; Russell Miller, MD, Columbia University; Tasnim Najaf, MD, Washington University School of Medicine; Stephanie Neves, Stanford Children's Health; J. Michael Newton, MD, Vanderbilt University; Sarah Obican, MD, University of Southern Florida; Jose L. Peiro, MD, PhD, Cincinnati Fetal Center; Patricia Santiago-Munoz, MD, Southwestern Medical Center; Saul Snowise, MD, Midwest Fetal Care Center; Shaun Steigman, MD, New York Presbyterian/Weill Cornell Medical Center; Ozan Turan, MD, PhD, University of Maryland; Amy J. Wagner, MD, Children's Hospital of Wisconsin. Anonymous responders from the following fetal centers: Mayo Clinic College of Medicine; Minneapolis-Midwest Fetal Care Center; Ohio State University; Evergreen Hospital, Seattle, Washington; University of California, Davis; University of California, San Francisco; University of Texas Health Science Center.
Publisher Copyright:
© 2020 John Wiley & Sons Ltd
PY - 2021/1
Y1 - 2021/1
N2 - Introduction: Prenatal work-up for congenital diaphragmatic hernia (CDH) is important for risk stratification, standardization, counseling, and optimal therapeutic choice. To determine current practice patterns regarding prenatal CDH work-up, including prenatal ultrasound and magnetic resonance imaging (MRI) use, and to identify areas for standardization of such evaluation between fetal centers. Methods: A survey regarding prenatal CDH work-up was sent to each member center of the North American Fetal Therapy Network (NAFTNet) (n = 36). Results: All responded. Sonographic measurement of lung-to-head ratio (LHR) was determined by all, 89% (32/36) of which routinely calculate observed-to-expected LHR. The method for measuring LHR varied: 58% (21/36) used a “trace” method, 25% (9/36) used “longest axis,” and 17% (6/36) used an “antero-posterior” method. Fetal MRI was routinely used in 78% (28/36) of centers, but there was significant variability in fetal lung volume measurement. Whereas all generated a total fetal lung volume, the planes, methodology and references values varied significantly. All evaluated liver position, 71% (20/28) evaluated stomach position and 54% (15/28) quantified the degree of liver herniation. More consistency in workup was seen between centers offering fetal intervention. Conclusion: Prenatal CDH work-up and management differs considerably among North American fetal diagnostic centers, highlighting a need for its standardization.
AB - Introduction: Prenatal work-up for congenital diaphragmatic hernia (CDH) is important for risk stratification, standardization, counseling, and optimal therapeutic choice. To determine current practice patterns regarding prenatal CDH work-up, including prenatal ultrasound and magnetic resonance imaging (MRI) use, and to identify areas for standardization of such evaluation between fetal centers. Methods: A survey regarding prenatal CDH work-up was sent to each member center of the North American Fetal Therapy Network (NAFTNet) (n = 36). Results: All responded. Sonographic measurement of lung-to-head ratio (LHR) was determined by all, 89% (32/36) of which routinely calculate observed-to-expected LHR. The method for measuring LHR varied: 58% (21/36) used a “trace” method, 25% (9/36) used “longest axis,” and 17% (6/36) used an “antero-posterior” method. Fetal MRI was routinely used in 78% (28/36) of centers, but there was significant variability in fetal lung volume measurement. Whereas all generated a total fetal lung volume, the planes, methodology and references values varied significantly. All evaluated liver position, 71% (20/28) evaluated stomach position and 54% (15/28) quantified the degree of liver herniation. More consistency in workup was seen between centers offering fetal intervention. Conclusion: Prenatal CDH work-up and management differs considerably among North American fetal diagnostic centers, highlighting a need for its standardization.
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U2 - 10.1002/pd.5859
DO - 10.1002/pd.5859
M3 - Article
C2 - 33125174
AN - SCOPUS:85096717033
SN - 0197-3851
VL - 41
SP - 200
EP - 206
JO - Prenatal Diagnosis
JF - Prenatal Diagnosis
IS - 2
ER -