{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:20:13Z","timestamp":1792513213723,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"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":[[2021,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the neonatal outcome of fetuses with isolated right\u2010sided congenital diaphragmatic hernia (iRCDH) based on prenatal severity indicators and antenatal management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective review of prospectively collected data on consecutive cases diagnosed with iRCDH before 30\u2009weeks' gestation in four fetal therapy centers, between January 2008 and December 2018. Data on prenatal severity assessment, antenatal management and perinatal outcome were retrieved. Univariate and multivariate logistic regression analysis were used to identify predictors of survival at discharge and early neonatal morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 265 patients assessed during the study period, we excluded 40 (15%) who underwent termination of pregnancy, two cases of unexplained fetal death, two that were lost to follow\u2010up, one for which antenatal assessment of lung hypoplasia was not available and six cases which were found to have major associated anomalies or syndromes after birth. Of the 214 fetuses with iRCDH included in the neonatal outcome analysis, 86 were managed expectantly during pregnancy and 128 underwent fetal endoscopic  tracheal occlusion (FETO) with a balloon. In the expectant\u2010management group, lung size measured by ultrasound or by magnetic resonance imaging was the only independent predictor of survival (observed\u2010to\u2010expected lung\u2010to\u2010head ratio (o\/e\u2010LHR) odds ratio (OR), 1.06 (95%\u2009CI, 1.02\u20131.11);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003). Until now, stratification for severe lung hypoplasia has been based on an o\/e\u2010LHR cut\u2010off of 45%. In cases managed expectantly, the survival rate was 15% (4\/27) in those with o\/e\u2010LHR \u2264\u200945% and 61% (36\/59) for o\/e\u2010LHR &gt;\u200945% (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001). However, the best o\/e\u2010LHR cut\u2010off for the prediction of survival at discharge was 50%, with a sensitivity of 78% and specificity of 72%. In the expectantly managed group, survivors with severe pulmonary hypoplasia stayed longer in the neonatal intensive care unit than did those with mildly hypoplastic lungs. In fetuses with an o\/e\u2010LHR \u2264\u200945% treated with FETO, survival rate was higher than in those with similar lung size managed expectantly (49\/120 (41%)\n                      <jats:italic>vs<\/jats:italic>\n                      4\/27 (15%);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.014), despite higher prematurity rates (gestational age at birth: 34.4\u2009\u00b1\u20092.7\u2009weeks\n                      <jats:italic>vs<\/jats:italic>\n                      36.8\u2009\u00b1\u20093.0\u2009weeks;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). In fetuses treated with FETO, gestational age at birth was the only predictor of survival (OR, 1.25 (95%\u2009CI, 1.04\u20131.50);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Antenatal measurement of lung size can predict survival in iRCDH. In fetuses with severe lung hypoplasia, FETO was associated with a significant increase in survival without an associated increase in neonatal morbidity. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.23115","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T03:25:36Z","timestamp":1600831536000},"page":"378-385","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Fetal endoscopic tracheal occlusion reverses the natural history of right\u2010sided congenital diaphragmatic hernia: European multicenter experience"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5029-7899","authenticated-orcid":false,"given":"F. M.","family":"Russo","sequence":"first","affiliation":[{"name":"Clinical Department of Obstetrics and Gynaecology, Fetal Medicine Unit University Hospitals Leuven  Leuven Belgium"},{"name":"Academic Department of Development and Regeneration, Woman and Child Biomedical Sciences, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6006-8408","authenticated-orcid":false,"given":"A.\u2010G.","family":"Cordier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, H\u00f4pital Bic\u00eatre, AP\u2010HP  Le Kremlin\u2010Bic\u00eatre France"},{"name":"Centre for Rare Diseases: Congenital Diaphragmatic Hernia, Clamart, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2022-9027","authenticated-orcid":false,"given":"D.","family":"Basurto","sequence":"additional","affiliation":[{"name":"Academic Department of Development and Regeneration, Woman and Child Biomedical Sciences, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5869-7109","authenticated-orcid":false,"given":"L.","family":"Salazar","sequence":"additional","affiliation":[{"name":"BCNatal, Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, CIBER\u2010ER University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5542-990X","authenticated-orcid":false,"given":"E.","family":"Litwinska","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute King's College Hospital  London 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Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, CIBER\u2010ER University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-0711","authenticated-orcid":false,"given":"K. 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