TY - JOUR
T1 - Fetal surgery using fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia
T2 - a single-center experience
AU - Idelson, Ana
AU - Tenenbaum-Gavish, Kinneret
AU - Danon, David
AU - Duvdevani, Nir Ram
AU - Bromiker, Ruben
AU - Klinger, Gil
AU - Orbach-Zinger, Sharon
AU - Almog, Anastasia
AU - Sharabi-Nov, Adi
AU - Meiri, Hamutal
AU - Nicolaides, Kypros H.
AU - Wiznitzer, Arnon
AU - Gielchinsky, Yuval
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023.
PY - 2024/7
Y1 - 2024/7
N2 - 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.
AB - 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.
KW - Congenital diaphragmatic hernia (CDH)
KW - FETO
KW - Fetal surgery
KW - Fetal therapy
KW - Fetoscopy
UR - http://www.scopus.com/inward/record.url?scp=85173086520&partnerID=8YFLogxK
U2 - 10.1007/s00404-023-07215-1
DO - 10.1007/s00404-023-07215-1
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C2 - 37789206
AN - SCOPUS:85173086520
SN - 0932-0067
VL - 310
SP - 345
EP - 351
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 1
ER -