{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:11:35Z","timestamp":1791619895050,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2018M643501"],"award-info":[{"award-number":["2018M643501"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2019T120851"],"award-info":[{"award-number":["2019T120851"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81800015"],"award-info":[{"award-number":["81800015"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018542","name":"Natural Science Foundation of Sichuan Province","doi-asserted-by":"publisher","award":["2022NSFSC0603"],"award-info":[{"award-number":["2022NSFSC0603"]}],"id":[{"id":"10.13039\/501100018542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>It is debated whether fetal endoscopic tracheal occlusion (FETO) is beneficial to fetuses with congenital diaphragmatic hernia (CDH) and whether FETO has different effects in moderate and severe CDH. We conducted a systematic review and meta\u2010analysis including the latest evidence to assess the overall effects of FETO on clinical outcomes of CDH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed, EMBASE, The Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database and Wanfang Database to retrieve eligible studies published before 8 September 2022. No language or study design restrictions were applied. Studies were included if CDH fetuses underwent FETO surgery and were compared with a cohort that underwent expectant management, with at least one outcome reported. The primary outcomes were mortality at 1, 6 and 12 months after birth, rates of pulmonary hypertension, use of extracorporeal membrane oxygenation (ECMO) and prematurity. Meta\u2010analysis was conducted to obtain pooled odds ratios (ORs) and mean differences. The quality of included studies and pooled evidence was also assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1187 CDH fetuses from 20 studies were included in the quantitative synthesis. FETO significantly reduced 1\u2010month (OR, 0.56 (95%\u2009CI, 0.34\u20130.93); <jats:italic>P\u2009=<\/jats:italic>\u20090.02, number needed to treat (NNT)\u2009=\u20097.67) and 6\u2010month (OR, 0.34 (95%\u2009CI, 0.18\u20130.65); <jats:italic>P\u2009=<\/jats:italic>\u20090.0009, NNT\u2009=\u20095.26) CDH mortality (moderate\/low quality of evidence). Subgroup analysis suggested that the effects of FETO on the rates of pulmonary hypertension and ECMO usage were significant in severe CDH (low\/moderate quality of evidence) but not in moderate CDH (low\/very low quality of evidence). FETO was also associated with an increased risk of preterm prelabor rupture of membranes before 37\u2009weeks' gestation (OR, 4.94 (95%\u2009CI, 2.25\u201310.88); <jats:italic>P\u2009&lt;<\/jats:italic>\u20090.0001, number needed to harm (NNH)\u2009=\u20093.13) and preterm birth before 37\u2009weeks (OR, 5.24 (95%\u2009CI, 3.33\u20138.23); <jats:italic>P\u2009&lt;<\/jats:italic>\u20090.00001, NNH\u2009=\u20092.79) (high\/moderate quality of evidence). However, FETO was not associated with severe complications, such as preterm birth before 32\u2009weeks, placental abruption or chorioamnionitis (very low\/low quality of evidence).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>FETO is associated with a reduction in mortality, rate of pulmonary hypertension and ECMO usage in severe CDH, while it reduces only the risk of mortality in moderate CDH. Although FETO increases the risk of late prematurity, it does not result in extreme prematurity. \u00a9 2023 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26164","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T08:49:32Z","timestamp":1674809372000},"page":"667-681","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia: systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"61","author":[{"given":"Y.","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Pulmonary Diseases, State Key Laboratory of Biotherapy and Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Diseases, State Key Laboratory of Biotherapy and Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Xie","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Diseases, State Key Laboratory of Biotherapy and Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Diseases, State Key Laboratory of Biotherapy and Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6070-6054","authenticated-orcid":false,"given":"Z.","family":"Yang","sequence":"additional","affiliation":[{"name":"Chengdu Women's and Children's Central Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1571-428X","authenticated-orcid":false,"given":"J.","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Diseases, State Key Laboratory of Biotherapy and Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2014.09.004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-3282"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4052"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.108871"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(03)00182-9"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2014.09.006"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1587331"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001675"},{"key":"e_1_2_8_10_1","first-page":"686","article-title":"Foetal endoscopic tracheal occlusion for severe congenital diaphragmatic hernia\u2009\u2013\u2009a systemic review and meta\u2010analysis of randomized controlled trials","volume":"64","author":"Shan W","year":"2014","journal-title":"J Pak Med Assoc"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2022.05.011"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-022-05170-7"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2027030"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2026983"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa035005"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.44"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1711"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-989275"},{"key":"e_1_2_8_19_1","first-page":"381","article-title":"Tracheal occlusion for fetuses with severe isolated left\u2010sided diaphragmatic hernia: a nonrandomized controlled experimental study","volume":"33","author":"Peralta CFA","year":"2011","journal-title":"Rev Bras Ginecol Obstet"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000311944"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31823d3aea"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10142"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12445"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12414"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000356437"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.02.023"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-016-2742-6"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13065"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001749"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5333"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-019-04484-3"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1159\/000491785"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20216"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.581809"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21993"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.00467"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5988"},{"issue":"560","key":"e_1_2_8_38_1","first-page":"e1","article-title":"The randomized Tracheal Occlusion to Accelerate Lung growth (TOTAL)\u2010trials on fetal surgery for congenital diaphragmatic hernia: reanalysis using pooled data","volume":"226","author":"Van Calster B","year":"2022","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2015.1114080"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.10.008"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26164","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T21:02:47Z","timestamp":1703106167000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.26164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,11]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1002\/uog.26164"],"URL":"https:\/\/doi.org\/10.1002\/uog.26164","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,11]]},"assertion":[{"value":"2022-06-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}