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Master Thesis

Une modification du volume pulmonaire observé/attendu mesuré sur deux IRM fœtales modifie-t-elle le pronostic d’un nouveau-né porteur d’une hernie de coupole diaphragmatique ?

Abstract : OBJECTIVES : To evaluate the impact on survival of a modification of observed/expected fetal lung volume (o/e FLV) measured with two MRIs in congenital diaphragmatic hernia. MATERIALS AND METHODS : We conducted a retrospective and multicentric study on 83 patients with prenatal diagnosis of CDH and o/e FLV measurements on two MRIs. The primary objective was to evaluate survival at discharge. The secondary objective explored the morbidity of CDH : number of days of invasive ventilation, non invasive ventilation, oxygenotherapy and duration of hospitalisation. We studied the modification of o/e FLV with two approaches : one with absolute difference between the 2 measurements (stable if difference <2%) and the second according to prognosis groups (good prognosis if o/e FLV > 30%, bad prognosis ≤ 30%). RESULTS : Amongst the fifty seven patients with an isolated left-sided CDH, there was no significant statistical difference in prediction of survival, time of ventilation and duration of hospitalisation, whichever approach we took. But the period of non invasive ventilation was influenced significantly by a modification of o/e FLV, especially when it decreased to a value ≤ 30% on the second MRI, whereas it was > 30% on the first one. CONCLUSION : It seems that only one measurement of o/e FLV is enough to evaluate the prognosis of left-sided isolated CDH. However, this result must be checked with a larger population.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01624626
Contributor : Jean-Hugues Morneau <>
Submitted on : Thursday, October 26, 2017 - 3:36:11 PM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM
Long-term archiving on: : Saturday, January 27, 2018 - 3:46:30 PM

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Sophie Schadt. Une modification du volume pulmonaire observé/attendu mesuré sur deux IRM fœtales modifie-t-elle le pronostic d’un nouveau-né porteur d’une hernie de coupole diaphragmatique ?. Médecine humaine et pathologie. 2017. ⟨dumas-01624626⟩

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