{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:58:45Z","timestamp":1791424725876,"version":"4.3.3"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,12,11]],"date-time":"2012-12-11T00:00:00Z","timestamp":1355184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the potential value of intrapulmonary artery Doppler velocimetry in predicting neonatal morbidity in fetuses with left\u2010sided congenital diaphragmatic hernia (<jats:styled-content style=\"fixed-case\">CDH<\/jats:styled-content>) treated with fetoscopic tracheal occlusion (<jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Observed\/expected lung\u2010to\u2010head ratio (O\/E\u2010<jats:styled-content style=\"fixed-case\">LHR<\/jats:styled-content>), and intrapulmonary Doppler pulsatility index and peak early\u2010diastolic reversed flow were evaluated within 24 h before <jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content> in a consecutive cohort of 51 fetuses with left\u2010sided <jats:styled-content style=\"fixed-case\">CDH<\/jats:styled-content> at between 24 and 33 weeks' gestation. Lung Doppler parameters were converted into Z\u2010scores and defined as abnormal if the pulsatility index had a <jats:italic>Z<\/jats:italic>\u2010score of &gt; 1.0 or the peak early\u2010diastolic reversed flow had a <jats:italic>Z<\/jats:italic>\u2010score of &gt; 3.5. The association of O\/E\u2010<jats:styled-content style=\"fixed-case\">LHR<\/jats:styled-content> and Doppler velocimetry with neonatal outcome was assessed using multiple linear or logistic regression analysis adjusted for gestational age at birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 26 fetuses that survived, 18 (69.2%) had normal and eight (30.8%) had abnormal Doppler values. O\/E\u2010<jats:styled-content style=\"fixed-case\">LHR<\/jats:styled-content> was not associated with neonatal morbidity in surviving fetuses. Compared with the group with normal Doppler parameters, cases with abnormal intrapulmonary Doppler were associated with a significant increase in the duration of mechanical ventilation (average increase of 21.2 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 9.99\u201332.5) days; <jats:italic>P<\/jats:italic> &lt; 0.01), conventional ventilation (15.2 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 7.43\u201323.0) days; <jats:italic>P<\/jats:italic> &lt; 0.01), high\u2010frequency ventilation (6.34 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.69\u201311.99) days; <jats:italic>P<\/jats:italic> &lt; 0.05), nitric oxide therapy (5.73 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.60\u201310.9) days; <jats:italic>P<\/jats:italic> &lt; 0.05), oxygen support (36.5 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 16.3\u201356.7) days; <jats:italic>P<\/jats:italic> &lt; 0.01), parenteral nutrition (19.1 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 7.53\u201330.7) days; <jats:italic>P<\/jats:italic> &lt; 0.01) and stay in neonatal intensive care unit (42.7 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 22.9\u201362.6) days; <jats:italic>P<\/jats:italic> &lt; 0.001), and with significantly higher rates of high\u2010frequency ventilation (87.5 vs 44.4%;<jats:italic>P<\/jats:italic> &lt; 0.05), oxygen requirement at 28 days of age (75.0 vs 11.1%; <jats:italic>P<\/jats:italic> &lt; 0.01), gastroesophageal reflux (62.5 vs 22.2%; <jats:italic>P<\/jats:italic> &lt; 0.05) and tube feeding at discharge (37.5 vs 5.56%; <jats:italic>P<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As previously reported, O\/E\u2010<jats:styled-content style=\"fixed-case\">LHR<\/jats:styled-content> did not predict neonatal morbidity. In contrast, intrapulmonary artery Doppler evaluation was predictive of neonatal morbidity in <jats:styled-content style=\"fixed-case\">CDH<\/jats:styled-content> fetuses treated with <jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content>.Copyright \u00a9 2012 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.11212","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T15:54:01Z","timestamp":1339430041000},"page":"59-65","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Usefulness of lung\u2010to\u2010head ratio and intrapulmonary arterial Doppler in predicting neonatal morbidity in fetuses with congenital diaphragmatic hernia treated with fetoscopic tracheal occlusion"],"prefix":"10.1002","volume":"41","author":[{"given":"R.","family":"Cruz\u2010Martinez","sequence":"first","affiliation":[{"name":"Department of Maternal\u2010Fetal Medicine Institute Cl\u00ednic of Gynecology, Obstetrics and Neonatology, Hospital Clinic\u2010IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Casta\u00f1on","sequence":"additional","affiliation":[{"name":"Department of Neonatal Surgery Hospital Sant Joan de Deu  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Moreno\u2010Alvarez","sequence":"additional","affiliation":[{"name":"Department of Maternal\u2010Fetal Medicine Institute Cl\u00ednic of Gynecology, Obstetrics and Neonatology, Hospital Clinic\u2010IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Acosta\u2010Rojas","sequence":"additional","affiliation":[{"name":"Department of Maternal\u2010Fetal Medicine Institute Cl\u00ednic of Gynecology, Obstetrics and Neonatology, Hospital Clinic\u2010IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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