Congenital diaphragmatic hernia ultrasound

Congenital diaphragmatic hernia Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

Overview

Ultrasonography findings in cases of CDH include polyhydramnios, an absent or intrathoracic stomach bubble, mediastinal shift towards the normal side and herniation into the chest. Ultrasound findings can also help detect the observed-to-expected lung-to-head ratio, which can assist in predicting survival rate.

Ultrasound

Prenatal ultrasonographic features of CDH include:

• polyhydramnios
• An absent or intrathoracic stomach bubble
• A mediastinal shift and cardiac shift away from the affected side
• herniation into the chest

Observed-to-expected lung-to-head ratio (O/E LHR)

Percentage of O/E LHR	Severity of Pulmonary Hypoplasia	Survival Rate
O/E LHR <15%	Extreme	Nearly 0%
O/E LHR 15-25%	Severe	~15%
O/E LHR 26-45%	Moderate	30%-75%
O/E LHR >45%	Mild	Very high

Case courtesy of Dr Hani Makky Al Salam, Radiopaedia.org, rID: 9512

Polyhydramnios: Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID: 37789