{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:58:41Z","timestamp":1791424721262,"version":"4.3.3"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,6,24]],"date-time":"2013-06-24T00:00:00Z","timestamp":1372032000000},"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":[[2013,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p><jats:italic>To evaluate the effect of early fetoscopic tracheal occlusion (<jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content>) (22\u201324 weeks' gestation) on pulmonary response and neonatal survival in cases of extremely severe isolated congenital diaphragmatic hernia (<jats:styled-content style=\"fixed-case\">CDH<\/jats:styled-content>)<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:italic>This was a multicenter study involving fetuses with extremely severe <jats:styled-content style=\"fixed-case\">CDH<\/jats:styled-content> (lung\u2010to\u2010head ratio\u2009&lt;\u20090.70, liver herniation into the thoracic cavity and no other detectable anomalies). Between August 2010 and December 2011, eight fetuses underwent early <jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content>. Data were compared with nine fetuses that underwent standard <jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content> and 10 without fetoscopic procedure from January 2006 to July 2010. <jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content> was performed under maternal epidural anesthesia, supplemented with fetal intramuscular anesthesia. Fetal lung size and vascularity were evaluated by ultrasound before and every 2 weeks after <jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content>. Postnatal therapy was equivalent for both treated fetuses and controls. Primary outcome was infant survival to 180 days and secondary outcome was fetal pulmonary response<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Maternal and fetal demographic characteristics and obstetric complications were similar in the three groups (<\/jats:italic>P\u2009&gt;\u2009<jats:italic>0.05). Infant survival rate was significantly higher in the early <jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content> group (62.5%) compared with the standard group (11.1%) and with controls (0%) (<\/jats:italic>P\u2009&lt;\u2009<jats:italic>0.01). Early <jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content> resulted in a significant improvement in fetal lung size and pulmonary vascularity when compared with standard <jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content> (<\/jats:italic>P\u2009&lt;\u2009<jats:italic>0.01)<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>Early <jats:styled-content style=\"fixed-case\">FETO<\/jats:styled-content> may improve infant survival by further increases of lung size and pulmonary vascularity in cases with extremely severe pulmonary hypoplasia in isolated <jats:styled-content style=\"fixed-case\">CDH<\/jats:styled-content>. This study supports formal testing of the hypothesis with a randomized controlled trial. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons Ltd<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12414","type":"journal-article","created":{"date-parts":[[2013,1,24]],"date-time":"2013-01-24T15:53:14Z","timestamp":1359042794000},"page":"70-76","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Early fetoscopic tracheal occlusion for extremely severe pulmonary hypoplasia in isolated congenital diaphragmatic hernia: preliminary results"],"prefix":"10.1002","volume":"42","author":[{"given":"R.","family":"Ruano","sequence":"first","affiliation":[{"name":"Obstetrics Department, Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Texas Children's Hospital Fetal Center and Department of Obstetrics and Gynecology Baylor College of Medicine  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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