Comparison of Prenatal Lung Volume Measurements Associated with Extracorporeal Membrane Oxygenation (ECMO) Utilization and Mortality in Congenital Diaphragmatic Hernia

jpedsurg.org

Prenatal imaging plays a central role in risk stratification for congenital diaphragmatic hernia (CDH). We sought to identify the most accurate predictor of mortality and ECMO utilization at early and late gestation timepoints amongst the various lung volume measurements: lung-to-head ratio (LHR), observed-to-expected (O/E) LHR, O/E total fetal lung volume (TFLV) and percent predicted lung volume (PPLV).

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Article · Jan 2026 · 1 min read

In brief

This study compares prenatal lung volume measurement techniques to predict mortality and ECMO need in CDH patients. Researchers evaluated LHR, O/E LHR, O/E TFLV, and PPLV at different gestational timepoints to determine which metric best stratifies risk and guides clinical decision-making for this complex congenital anomaly.

Multiple prenatal lung volume metrics (LHR, O/E LHR, O/E TFLV, PPLV) are used to predict CDH outcomes but vary in accuracy.
Accurate prenatal risk stratification for CDH mortality and ECMO need depends on both measurement type and gestational timing.
Comparing predictive accuracy of lung volume measurements helps clinicians choose optimal prenatal assessment tools for CDH counseling.
Early vs late gestation timepoints may require different lung volume metrics for best prognostic accuracy in CDH cases.

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