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July 6, 1994

Cardiac Function in Fetuses With Congenital Diaphragmatic Hernia-Reply

Author Affiliations

University of California—San Francisco

JAMA. 1994;272(1):29-30. doi:10.1001/jama.1994.03520010039020

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In Reply.  —Thus far, no single factor or factors have allowed prediction of survival in prenatally diagnosed fetuses with CDH. We are in the process of reviewing 161 prenatally diagnosed CDH infants referred to the fetal treatment center since January 1990. Preliminary findings of a retrospective blinded evaluation of detailed prenatal sonograms in 40 fetuses suggest that the degree of mediastinal shift and the position of the liver significantly predict outcome. Also, we hope that fetal cardiac anatomy and/or function may contribute to our understanding of the pathophysiology of CDH, and we are in the process of correlating fetal echocardiographic parameters with outcome. Perhaps echocardiographic measurement of left ventricular volume and function combined with sonographic measurement of mediastinal shift and liver position will allow us to better predict which fetuses will live and which will die.

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