This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Hratch L. Karamanoukian, MD; Philip L. Glick, MD
Buffalo Institute of Fetal Therapy Buffalo, NY

JAMA. 1994;272(1):29.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

— We commend Dr Harrison and colleagues¹ for undertaking a thorough study that details the natural history of fetuses with congenital diaphragmatic hernia (CDH). However, it is still impossible to prospectively determine which fetuses or neonates will or will not survive, as only the latter group of patients may be considered for fetal surgical correction of CDH. The major challenge to investigators in this field has been to identify prenatal risk factors in the fetus with CDH that will more accurately predict outcome (and better select candidates for fetal surgery). Although the study by Harrison and colleagues begins to address this challenge, we have several questions.

First, subjects enrolled in the study had "isolated CDH" based on "ultrasound studies and karyotypic analysis." Recent studies have suggested that there may be a significant but subtle cardiac disease in CDH, manifested as maldevelopment of the left ventricle.² . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?