Fetal Therapy for Congenital Pulmonary Malformations: A Prospective Population-Based National Cohort Study.

IF 2.7 2区医学 Q2 GENETICS & HEREDITY

Prenatal Diagnosis Pub Date : 2024-08-13 DOI:10.1002/pd.6646

Mathilde Weber, Isabelle Monier, Makan Rahshenas, Laurent J Salomon, Nicolas Sananes, Vanina Castaigne, Véronique Houfflin-Debarge, Jean-Marie Jouannic, Jérôme Massardier, Vassilis Tsatsaris, Babak Khoshnood, Nathalie Lelong, Christophe Delacourt, Alexandra Benachi

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引用次数: 0

Abstract

Objective: To assess the frequency of fetal therapy for fetuses with congenital pulmonary malformations (CPMs) and to investigate their short-term outcomes.

Method: The study population included 435 singleton fetuses diagnosed with CPMs from a national population-based cohort study in France in 2015-2018. Information was obtained from medical records on CPM volume ratio (CVR), signs of compression, fetal therapy and perinatal outcomes. The characteristics and outcomes of fetuses with and without fetal therapy were compared using a univariate test.

Results: Twenty six fetuses (6.0%, 95% CI: 4.1-8.6) received at least one fetal therapy including thoracoamniotic shunts only (n = 3), antenatal steroids only (n = 12), and a combination of several therapies including thoracentesis and amniodrainage, in addition to shunts and steroids (n = 11). Compared with fetuses without fetal therapy, those who did have higher CVR (1.6 ± 0.3 vs. 0.7 ± 0.04, p < 0.001) and more severe signs of compression (73.1% vs. 12.8%, p < 0.001). The proportion of live births after fetal therapy was 84.6% versus 98.5% (p < 0.001) for those without fetal therapy and the hospital mortality rate was 13.6% versus 1.0% (p = 0.004), respectively.

Conclusion: A small minority of fetuses with CPMs underwent fetal therapy. These patients had a lower survival compared with those who did not receive fetal therapy.

Trial registration: NCT02352207.

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先天性肺畸形的胎儿治疗：一项以人口为基础的前瞻性全国队列研究。

摘要评估先天性肺畸形（CPM）胎儿接受胎儿治疗的频率，并调查其短期疗效：研究对象包括2015-2018年法国一项全国性人群队列研究中确诊为先天性肺畸形的435名单胎胎儿。研究人员从医疗记录中获取了有关CPM容积比（CVR）、压迫征象、胎儿治疗和围产期结局的信息。通过单变量检验比较了接受和未接受胎儿治疗的胎儿的特征和结局：26名胎儿（6.0%，95% CI：4.1-8.6）接受了至少一种胎儿治疗，包括仅胸羊膜腔分流术（3例）、仅产前类固醇（12例），以及除分流术和类固醇外还包括胸腔穿刺术和羊膜腔引流术在内的多种疗法组合（11例）。与未进行胎儿治疗的胎儿相比，进行了胎儿治疗的胎儿有更高的 CVR（1.6 ± 0.3 vs. 0.7 ± 0.04，P 结语）：少数 CPM 胎儿接受了胎儿治疗。与未接受胎儿治疗的患者相比，这些患者的存活率较低：试验注册：NCT02352207。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prenatal Diagnosis 医学-妇产科学

CiteScore

5.80

自引率

13.30%

发文量

204

审稿时长

2 months

期刊介绍： Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling