Abstract

Erick Nestianu*, Cristina Guramba Bradeanu, Ioana Dragan and Radu Vladareanu

ABSTRACT

Aims: We wanted to find correlations between the ultrasound examination of pregnancies with diaphragmatic hernia and the MRI examination that followed in these cases. Fetal MRI is used to confirm, complete and make the differential diagnosis in difficult cases. In some cases, it can also bring forth now information regarding the prognosis. Methods: This was a retrospective study of 6 pregnancies that were recommended to a third-degree maternity from multiple diagnosis centers. The ultrasounds and MRI examinations were performed in specialized fetal medicine study centers. The information obtained about the progression of pulmonary hypoplasia helped decide the prognosis and treatment of these cases. Results: The diagnosis was made in the second trimester in 4 cases and in the third trimester in the other 2 cases. We described the herniated organs, the dimensions of the hernia and the remaining lung capacity so that we could correctly evaluate the prognosis. We also used the Lung to Head Ratio (LHR) to try and better determine the degree of lung hypoplasia. Conclusions: Considering diaphragmatic hernia as solitary malformation, the localization (on the left side, right side or bilateral) corresponds with international statistics. High quality ultrasound followed by an MRI examination helped correctly appreciate the prognostic, treatment possibilities and the total affected lung volume. With the expansion of highly specialized fetal medicine study centers, there will be an increase in the diagnosis capacity. The MRI follow up will increase the certainty of the diagnosis and improve the overall quality of the medical care.