Avaliação prognóstica de fetos portadores de hérnia diafragmática congênita isolada: observado/esperado (O/E) LHR como preditor de morbi-mortalidade

Abstract

Congenital diaphragmatic hernia (CDH) is a condition characterized by a defect in the diaphragm leading to protrusion of the abdominal contents into the thoracic cavity affect-ing the normal development of the fetal lungs. Pathophysiology is characterized by the combination of pulmonary hypoplasia associated with pulmonary hypertension. Prenatal assessment of O / E LHR and the liver position at ultrasound are used to diagnose and predict postnatal results. The aim of the study was to characterize fetuses with HDC, followed up at a Fetal Medicine Center and to compare the ability of the O / E LHR ratio to predict the survival rate of these fetuses in order to assess the degree of pulmonary hypoplasia. This is a prospective descriptive study in which we sought to characterize pre-natal ultrasound findings and correlate with their postnatal results. The study found a high mortality rate of these fetuses, regardless of the prognostic evaluation of the O / E LHR, being necessary the elaboration of strategies to be adopted by the assistance team in order to improve the postnatal results.