Congenital diaphragmatic hernia without herniation of the liver: Does the lung-to-head ratio predict survival?

The purpose of the present study was to determine the ability of lung-to-he ad ratio to predict survival and need for extracorporeal membrane oxygenati on support in fetuses with left congenital diaphragmatic hernia without her niation of the liver into the chest. The perinatal records of 20 fetuses wi th isolated left congenital diaphragmatic hernia without herniation of the left lobe of the liver into the chest were reviewed. Fetuses were stratifie d into two groups depending on lung-to-head ratio: those with a ratio of le ss than 1.4 (historically a poor prognosis group) and those with a ratio of greater than 1.4. The outcome of both groups was compared with chi-square analysis. Eight of 11 fetuses with a lung-to-head ratio greater than 1.4 su rvived, whereas 8 of 9 fetuses with a ratio of less than 1.4 survived. No d ifferences were noted in the need for extracorporeal membrane oxygenation s upport or survival between the two groups. Fetuses with a prenatally diagno sed left congenital diaphragmatic hernia without herniation of liver into t he chest have a favorable the presence of a low lung-to-head prognosis even in ratio.