Evaluation of pulmonary vascularization in fetuses with Congenital Diaphragmatic Hernia undergoing conservative treatment or fetal intervention through fetoscopic tracheal balloon placement

• Grant number: 13/12493-1
• Support Opportunities: Scholarships abroad - Research
• Start date: November 11, 2013
• End date: November 10, 2014
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Ingrid Schwach Werneck Britto
• Grantee: Ingrid Schwach Werneck Britto
• Host Investigator: Michael Antony Belfort
• Host Institution: Hospital Central. Santa Casa de Misericórdia de São Paulo. Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP). São Paulo , SP, Brazil
• Institution abroad: Baylor College of Medicine, United States

Abstract

The purpose of this study is to determine the levels of vascularity by three-dimensional power Doppler ultrasound in fetuses with congenital diaphragmatic hernia (CDH) and evaluate the difference of these indices in the conservative treatment and surgical treatment by fetoscopy. The study aims to initially determine the rates of pulmonary vascularization in normal fetuses by three-dimensional power Doppler ultrasound and its correlation with lung volume. Furthermore, in fetuses with CDH, to evaluate the correlation between vascularity indices for predicting pulmonary hypoplasia and pulmonary hypertension in newborns. Method: There will be a longitudinal study of normal fetuses (group 1 - control) fetuses with CDH in expectant management (group 2) and fetuses with CDH treated through fetoscopic tracheal balloon placement (group 3). The study will be evaluated in three gestational periods-24, 28 and 32 weeks gestation. The following rates are obtained during the exam: vascular index (VI), flow index (FI), vasculature flow index (VFI), and Doppler flow evaluation of pulmonary arteries in fetuses from group 1, 2 and 3. The neonatal hospital course will be assessed through a review of the medical records to determine pulmonary parameters such as total time on mechanical ventilation, oxygenation index, need and length of time on high frequency ventilation, need and length of time on inhaled nitric oxide. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

BRITTO, INGRID SCHWACH WERNECK; SANANES, NICOLAS; OLUTOYE, OLUYINKA O.; CASS, DARRELL L.; SANGI-HAGHPEYKAR, HALEH; LEE, TIMOTHY C.; CASSADY, CHRISTOPHER I.; MEHOLLIN-RAY, AMY; WELTY, STEPHEN; FERNANDES, CARACIOLO; et al. Standardization of Sonographic Lung-to-Head Ratio Measurements in Isolated Congenital Diaphragmatic Hernia Impact on the Reproducibility and Efficacy to Predict Outcomes. JOURNAL OF ULTRASOUND IN MEDICINE, v. 34, n. 10, p. 1721-1727, OCT 2015. (13/12493-1)

SANANES, NICOLAS; BRITTO, INGRID; AKINKUOTU, ADESOLA C.; OLUTOYE, OLUYINKA O.; CASS, DARRELL L.; SANGI-HAGHPEYKAR, HALEH; LEE, TIMOTHY C.; CASSADY, CHRISTOPHER I.; MEHOLLIN-RAY, AMY; WELTY, STEPHEN; et al. Improving the Prediction of Neonatal Outcomes in Isolated Left-Sided Congenital Diaphragmatic Hernia by Direct and Indirect Sonographic Assessment of Liver Herniation. JOURNAL OF ULTRASOUND IN MEDICINE, v. 35, n. 7, p. 1437-1443, JUL 1 2016. (13/12493-1)

SANANES, NICOLAS; RODO, CARLOTA; LUIS PEIRO, JOSE; BRITTO, INGRID SCHWACH WERNECK; SANGI-HAGHPEYKAR, HALEH; FAVRE, ROMAIN; JOAL, ARNAUD; GAUDINEAU, ADRIEN; DA SILVA, MARCOS MARQUES; TANNURI, UENIS; et al. Prematurity and fetal lung response after tracheal occlusion in fetuses with severe congenital diaphragmatic hernia. Journal of Maternal-Fetal & Neonatal Medicine, v. 29, n. 18, p. 3030-3034, 2016. (13/12493-1)