The relationship between three signs of fetal magnetic resonance imaging and severity of congenital diaphragmatic hernia

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To seek a simple approach for prenatally classifying congenital diaphragmatic hernia (CDH) severity using fetal magnetic resonance imaging (MRI) markers.

Study design:

A retrospective, multicenter study using questionnaires to investigate fetal MRI findings. We included fetuses prenatally diagnosed with isolated left-sided CDH and delivered after 36 weeks of gestation. We focused on three fetal MRI morphological signs: incomplete pulmonary baseline (IPB), liver up (LU) and retrocardiac stomach (RCS). We also evaluated the fetal MRI score defined as the total number of positive signs; the primary outcome was survival at discharge.


In 256 patients (from 56 institutions), IPB, LU and RCS findings correlated with lower survival: odds ratio (95% confidence interval), 0.16 (0.08 to 0.33); 0.24 (0.12 to 0.51); and 0.14 (0.07 to 0.28); respectively. Patients with higher fetal MRI scores had a higher mortality rate.


IPB, LU and RCS on fetal MRI are related to CDH severity.

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We thank the persons in charge of the participating institutions for responding to our research.

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Correspondence to T Hattori.

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Tetsuo Hattori wrote the first draft of the manuscript. The remaining authors declare no conflict of interest.

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Hattori, T., Hayakawa, M., Ito, M. et al. The relationship between three signs of fetal magnetic resonance imaging and severity of congenital diaphragmatic hernia. J Perinatol 37, 265–269 (2017) doi:10.1038/jp.2016.208

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