Fetal surgery using fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia: a single-center experience

Ana Idelson, Kinneret Tenenbaum-Gavish, David Danon, Nir Ram Duvdevani, Ruben Bromiker, Gil Klinger, Sharon Orbach-Zinger, Anastasia Almog, Adi Sharabi-Nov, Hamutal Meiri, Kypros H. Nicolaides, Arnon Wiznitzer, Yuval Gielchinsky*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To provide a comprehensive report of the experience gained in the prenatal treatment of congenital diaphragmatic hernia (CDH) using fetoscopic endoluminal tracheal occlusion (FETO) following its implementation at a newly established specialized fetal medicine center. Methods: Mothers of fetuses with severe CDH were offered prenatal treatment by FETO. Results: Between 2018 and 2021, 16 cases of severe CDH underwent FETO. The median gestational age (GA) at balloon insertion was 28.4 weeks (IQR 27.8–28.6). The median GA at delivery was 37 weeks (IQR 34.4–37.8). The survival rate was 8/16 cases (50%). None of the survivors required home oxygen therapy at 6 months of age. Comparison between the survivors and deceased showed that survivors had balloon insertion 1 week earlier (27.8 vs. 28.4 weeks, p = 0.007), a higher amniotic fluid level change between pre- to post-FETO (3.4 vs 1.3, p = 0.024), a higher O/E LHR change between pre- to post-FETO (50.8 vs. 37.5, p = 0.047), and a GA at delivery that was 2 weeks later (37.6 vs. 35.4 weeks, p = 0.032). Conclusions: The survival rate at 6 months of age in cases of severe CDH treated with FETO in our center was 50%. Our new fetal medicine center matches the performance of other leading international centers.

Original languageEnglish
Pages (from-to)345-351
Number of pages7
JournalArchives of Gynecology and Obstetrics
Volume310
Issue number1
DOIs
StatePublished - Jul 2024

Keywords

  • Congenital diaphragmatic hernia (CDH)
  • FETO
  • Fetal surgery
  • Fetal therapy
  • Fetoscopy

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