{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:20:07Z","timestamp":1792513207390,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"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":[[2021,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The long\u2010term morbidity associated with isolated left\u2010sided congenital diaphragmatic hernia (CDH) has been described previously. However, antenatal criteria impacting gastrointestinal morbidity (GIM) are not yet defined. The objective of this study was to evaluate the effect of fetal stomach position on the risk of GIM at 2\u2009years of age in children with left\u2010sided CDH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective, observational multicenter cohort study of data obtained from January 2010 to January 2014, that included patients whose fetus had isolated left\u2010sided CDH, with or without fetal endoscopic tracheal occlusion (FETO). Prenatal maternal, fetal and pediatric data were collected. Fetal stomach position was evaluated <jats:italic>a posteriori<\/jats:italic> by two observers, using ultrasound images at the level of the four\u2010chamber view of the heart that had been obtained to calculate the observed\u2010to\u2010expected lung\u2010area\u2010to\u2010head\u2010circumference ratio (O\/E\u2010LHR). Fetal stomach position was graded as follows: Grade 1, stomach not visualized; Grade 2, stomach visualized anteriorly, next to the apex of the heart, with no structure in between the stomach and the sternum; Grade 3, stomach visualized alongside the left ventricle of the heart, and abdominal structures anteriorly; or Grade 4, as Grade 3 but with stomach posterior to the level of the atrioventricular heart valves. The primary outcome was GIM at 2\u2009years of age, assessed in a composite manner, including the occurrence of gastroesophageal reflux disease, need for gastrostomy, duration of parenteral and enteral nutrition and persistence of oral aversion. Regression analysis was performed in order to investigate the effect of O\/E\u2010LHR, stomach position and FETO on various GIM outcome variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010seven patients with fetal left\u2010sided CDH were included in the analysis. Thirteen (27.7%) infants did not meet the criterion of exclusive oral feeding at 2\u2009years of age. Fetal stomach position grade was associated significantly and independently with the duration of parenteral nutrition (odds ratio (OR), 19.86; <jats:italic>P<\/jats:italic>\u2009=\u20090.031) and persistence of oral aversion at 2\u2009years (OR, 3.40; <jats:italic>P<\/jats:italic>\u2009=\u20090.006). On multivariate analysis, O\/E\u2010LHR was predictive of the need for prosthetic patch repair, but not for GIM. FETO did not seem to affect the risk of GIM at 2\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In isolated left\u2010sided CDH, fetal stomach position is the only factor that is predictive of GIM at 2\u2009years of age. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.22086","type":"journal-article","created":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T05:22:45Z","timestamp":1590643365000},"page":"959-967","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Prenatal stomach position predicts gastrointestinal morbidity at 2\u2009years in fetuses with left\u2010sided congenital diaphragmatic hernia"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6006-8408","authenticated-orcid":false,"given":"A. G.","family":"Cordier","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics Antoine B\u00e9cl\u00e8re Hospital, Paris\u2010Sud University  Clamart France"},{"name":"Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia  Clamart France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Laup","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Antoine B\u00e9cl\u00e8re Hospital, Paris\u2010Sud University  Clamart France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Letourneau","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Antoine B\u00e9cl\u00e8re Hospital, Paris\u2010Sud University  Clamart France"},{"name":"Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia  Clamart France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Le Sache","sequence":"additional","affiliation":[{"name":"Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia  Clamart France"},{"name":"Department of Neonatal Pediatrics Bic\u00eatre Hospital, Paris\u2010Sud University  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Fouquet","sequence":"additional","affiliation":[{"name":"Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia  Clamart France"},{"name":"Department of Pediatric Surgery Bic\u00eatre Hospital, Paris\u2010Sud University  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2329-6575","authenticated-orcid":false,"given":"M. V.","family":"Senat","sequence":"additional","affiliation":[{"name":"Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia  Clamart France"},{"name":"Department of Gynecology and Obstetrics Bic\u00eatre Hospital, Paris\u2010Sud University  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Perrotin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Fetal Medicine Regional University Hospital, Francois Rabelais University  Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Rosenblatt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Robert Debr\u00e9 Hospital, APHP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Sananes","sequence":"additional","affiliation":[{"name":"Department of Maternal\u2013Fetal Medicine Strasbourg University Hospital  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7890-3790","authenticated-orcid":false,"given":"J. 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