Foetal endoscopic tracheal occlusion for severe congenital diaphragmatic hernia--a systemic review and meta-analysis of randomized controlled trials.

To evaluate and analyze the effect of foetal endocsopic tracheal occlusion (FETO) therapy on survival rates of neonatal with congenital diaphragmatic hernia and maternal complications. We performed a systemic review and meta-analysis of three randomized controlled trials (RCTs). The combined data on neonatal survival rates, length of gestational age and rates of premature rupture of membrane from these studies were retrieved and analysed. Pooled data of these three RCTs revealed that FETO provided neonates with severe congenital diaphragmatic hernia a significantly higher survival rate: 27/48 VS 12/52. The odds ratio was 5.95 (95% CI: 2.11 - 16.79, p < 0.0008). The gestational age (week) of FETO group was shorter than postnatal standard therapy group. The mean difference was -3.43 (95% CI: -6.82 - -0.04, p < 0.05). FETO group also had a significantly greater rate of premature rupture of membranes than control group with the odds ratio of 3.35 (95% CI: 2.11 - 16.79, p < 0.0008). Foetal endoscopic tracheal occlusion improved neonatal survival rate but also increased major maternal complications including preterm delivery and premature rupture of membranes.