{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:02:40Z","timestamp":1792555360106,"version":"4.5.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,8,30]],"date-time":"2020-08-30T00:00:00Z","timestamp":1598745600000},"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; Gyne"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the impact of fetal endoscopic tracheal occlusion (FETO) on improving survival of fetuses with severe left\u2010sided congenital diaphragmatic hernia (CDH), as compared with contemporaneous cases managed expectantly during pregnancy, in a country with suboptimal neonatal management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective cohort study, consecutive fetuses with isolated left\u2010sided CDH, normal karyotype and severe pulmonary hypoplasia (defined as liver herniation and observed\/expected lung\u2010to\u2010head circumference ratio below 26%) were selected for FETO at less than 32\u2009weeks of gestation in a single tertiary referral center in Queretaro, Mexico. Postnatal outcome (survival up to 28\u2009days after birth) was compared between fetuses treated with FETO and contemporaneous cases with similar lung size managed expectantly during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010five fetuses with isolated severe left\u2010sided CDH treated with FETO were matched individually with 25 cases managed expectantly during pregnancy. Endotracheal placement of the balloon was performed successfully on the first attempt in all cases. The median gestational age (GA) at balloon placement was 29.1 (range, 25.6\u201331.8) weeks and 34.1 (range, 30.0\u201336.1) weeks at balloon removal. There were no technical problems with the introduction or removal of the balloon in any cases. The median GA at delivery was significantly lower in the group treated with FETO than in those managed expectantly (35.3 <jats:italic>vs<\/jats:italic> 37.7\u2009weeks; <jats:italic>P<\/jats:italic>\u2009=\u20090.04). The survival rate was significantly higher in the group treated with FETO than in those without fetal intervention (32% <jats:italic>vs<\/jats:italic> 0%; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In settings with suboptimal neonatal management, FETO was associated with improved neonatal survival in fetuses with isolated left\u2010sided CDH and severe pulmonary hypoplasia. Copyright \u00a9 2020 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.21993","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T16:37:00Z","timestamp":1582043820000},"page":"516-521","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Survival outcome in severe left\u2010sided congenital diaphragmatic hernia with and without fetal endoscopic tracheal occlusion in a country with suboptimal neonatal management"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5999-866X","authenticated-orcid":false,"given":"R.","family":"Cruz\u2010Mart\u00ednez","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Center, Fetal Medicine Mexico  Queretaro Mexico"},{"name":"Department of Fetal Surgery Hospital de Especialidades del Ni\u00f1o y la Mujer \u2018Dr. Felipe N\u00fa\u00f1ez\u2010Lara\u2019  Queretaro Mexico"},{"name":"Universidad Aut\u00f3noma del Estado de Hidalgo  Hidalgo Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Mart\u00ednez\u2010Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, Fetal Medicine Mexico  Queretaro Mexico"},{"name":"Department of Fetal Surgery Hospital de Especialidades del Ni\u00f1o y la Mujer \u2018Dr. Felipe N\u00fa\u00f1ez\u2010Lara\u2019  Queretaro Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"G\u00e1mez\u2010Varela","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, Fetal Medicine Mexico  Queretaro Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Nieto\u2010Castro","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, Fetal Medicine Mexico  Queretaro Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Luna\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, Fetal Medicine Mexico  Queretaro Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Ju\u00e1rez\u2010Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, Fetal Medicine Mexico  Queretaro Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"L\u00f3pez\u2010Briones","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, Fetal Medicine Mexico  Queretaro Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Guadarrama\u2010Mora","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, Fetal Medicine Mexico  Queretaro Mexico"},{"name":"Department of Fetal Surgery Hospital de Especialidades del Ni\u00f1o y la Mujer 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