Rachel Shulman1, Teresa N Sparks1, Kristen Gosnell2, Cinthia Blat1, Mary E Norton1, Hanmin Lee3, Juan Gonzalez-Velez1, Ruth B Goldstein2. 1. Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco. 2. Department of Obstetrics, Gynecology, and Reproductive Sciences, Fetal Treatment Center, University of California, San Francisco. 3. Department of Surgery, Fetal Treatment Center, University of California, San Francisco.
Abstract
OBJECTIVE: To examine the relationship between cardiomediastinal shift angle (CMSA) and adverse perinatal outcomes and hydrops in cases of congenital pulmonary airway malformation (CPAM). STUDY DESIGN: This retrospective study evaluated CPAM cases referred to our institution from 2008 to 2015. The primary outcome was a composite score for adverse perinatal outcome. CMSA was measured for each case and evaluated for its association with the primary outcome. The prediction accuracy of CMSA for adverse perinatal outcome was assessed using receiver operator characteristic (ROC) curves. RESULTS: Eighteen (21.2%) of the 85 cases experienced an adverse perinatal outcome. Increases in CMSA were associated with adverse perinatal outcomes and hydrops in bivariate analyses. Adjusted analyses found each 10-degree increase in CMSA to be associated with increased odds of an adverse perinatal outcome (adjusted odds ratio [aOR] 2.2, 95% confidence interval [CI]: 1.4-3.3) and hydrops (aOR 3.0, 95% CI: 1.5-6.1). CMSA performed well and was comparable to CPAM volume ratio in predicting adverse perinatal outcomes (area under the curve 0.81 and 0.84, respectively). CONCLUSION: We describe a novel measurement of mediastinal shift in cases of CPAM and its relationship with adverse perinatal outcomes and hydrops. These findings may shape the evaluation and management of CPAMs, improve our understanding of their prognosis, and influence patient counseling. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: To examine the relationship between cardiomediastinal shift angle (CMSA) and adverse perinatal outcomes and hydrops in cases of congenital pulmonary airway malformation (CPAM). STUDY DESIGN: This retrospective study evaluated CPAM cases referred to our institution from 2008 to 2015. The primary outcome was a composite score for adverse perinatal outcome. CMSA was measured for each case and evaluated for its association with the primary outcome. The prediction accuracy of CMSA for adverse perinatal outcome was assessed using receiver operator characteristic (ROC) curves. RESULTS: Eighteen (21.2%) of the 85 cases experienced an adverse perinatal outcome. Increases in CMSA were associated with adverse perinatal outcomes and hydrops in bivariate analyses. Adjusted analyses found each 10-degree increase in CMSA to be associated with increased odds of an adverse perinatal outcome (adjusted odds ratio [aOR] 2.2, 95% confidence interval [CI]: 1.4-3.3) and hydrops (aOR 3.0, 95% CI: 1.5-6.1). CMSA performed well and was comparable to CPAM volume ratio in predicting adverse perinatal outcomes (area under the curve 0.81 and 0.84, respectively). CONCLUSION: We describe a novel measurement of mediastinal shift in cases of CPAM and its relationship with adverse perinatal outcomes and hydrops. These findings may shape the evaluation and management of CPAMs, improve our understanding of their prognosis, and influence patient counseling. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Paul J Yong; Peter Von Dadelszen; Daniela Carpara; Ken Lim; Nancy Kent; Francine Tessier; Marie-France Delisle; Titus Wong; Geoffrey Blair; Erik D Skarsgard Journal: Fetal Diagn Ther Date: 2012-02-03 Impact factor: 2.587
Authors: Darrell L Cass; Oluyinka O Olutoye; Christopher I Cassady; Kenneth J Moise; Anthony Johnson; Ramesha Papanna; David A Lazar; Nancy A Ayres; Bella Belleza-Bascon Journal: J Pediatr Surg Date: 2011-02 Impact factor: 2.545
Authors: Stacey Ehrenberg-Buchner; Alyssa M Stapf; Deborah R Berman; Robert A Drongowski; George B Mychaliska; Marjorie C Treadwell; Shaun M Kunisaki Journal: Am J Obstet Gynecol Date: 2012-11-15 Impact factor: 8.661
Authors: Casper M Kersten; Sergei M Hermelijn; Dhanya Mullassery; Nagarajan Muthialu; Nazan Cobanoglu; Silvia Gartner; Pietro Bagolan; Carmen Mesas Burgos; Alberto Sgrò; Stijn Heyman; Holger Till; Janne Suominen; Maarten Schurink; Liesbeth Desender; Paul Losty; Henri Steyaert; Suzanne Terheggen-Lagro; Martin Metzelder; Arnaud Bonnard; Rony Sfeir; Michael Singh; Iain Yardley; Noor R V M Rikkers-Mutsaerts; Cornelis K van der Ent; Niels Qvist; Des W Cox; Robert Peters; Michiel A G E Bannier; Lucas Wessel; Marijke Proesmans; Michael Stanton; Edward Hannon; Marco Zampoli; Francesco Morini; Harm A W M Tiddens; René M H Wijnen; Johannes M Schnater Journal: Children (Basel) Date: 2022-07-30