S. Cullen, Ericalyn Kasdorf, Sara Cohen, A. Kovanlikaya, Brittany Roser, Corrina Oxford-Horrey, Cynthia Perez, Catherine Chang
{"title":"Ultrasound Differentiation of Twins with Discordant Congenital Diaphragmatic Hernia in the Delivery Room","authors":"S. Cullen, Ericalyn Kasdorf, Sara Cohen, A. Kovanlikaya, Brittany Roser, Corrina Oxford-Horrey, Cynthia Perez, Catherine Chang","doi":"10.1055/s-0044-1786166","DOIUrl":null,"url":null,"abstract":"Most infants with prenatally diagnosed congenital diaphragmatic hernia (CDH) are intubated rapidly after birth to optimize oxygenation and ventilation while avoiding abdominal distention and high mean airway pressures. A twin pregnancy complicated by one twin with a CDH diagnosis is a rare event and is associated with preterm delivery and low birth weight compared to singletons with CDH. In rare cases of discordant CDH in twin pregnancies with an absence of external distinguishing features (similar weights, fetal presentation, and sex), it may be difficult to quickly determine which twin has CDH in the delivery room (DR), raising ambiguity about the best management of both infants. This case describes the successful use of ultrasound (US) in the DR to rapidly diagnose the presence or absence of CDH in discordant twins. By developing a resuscitation algorithm and using in situ simulations prior to delivery, the twin with CDH was rapidly identified, intubated, and transported to the neonatal intensive care unit (NICU) for further management. The twin without CDH received routine care and was transferred to the well-baby nursery. Interprofessional planning and simulation may be used to design a safe resuscitation plan incorporating US diagnosis of diaphragmatic anomalies into the Neonatal Resuscitation Program (NRP) algorithm.","PeriodicalId":42412,"journal":{"name":"Journal of Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1000,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Fetal Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/s-0044-1786166","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Most infants with prenatally diagnosed congenital diaphragmatic hernia (CDH) are intubated rapidly after birth to optimize oxygenation and ventilation while avoiding abdominal distention and high mean airway pressures. A twin pregnancy complicated by one twin with a CDH diagnosis is a rare event and is associated with preterm delivery and low birth weight compared to singletons with CDH. In rare cases of discordant CDH in twin pregnancies with an absence of external distinguishing features (similar weights, fetal presentation, and sex), it may be difficult to quickly determine which twin has CDH in the delivery room (DR), raising ambiguity about the best management of both infants. This case describes the successful use of ultrasound (US) in the DR to rapidly diagnose the presence or absence of CDH in discordant twins. By developing a resuscitation algorithm and using in situ simulations prior to delivery, the twin with CDH was rapidly identified, intubated, and transported to the neonatal intensive care unit (NICU) for further management. The twin without CDH received routine care and was transferred to the well-baby nursery. Interprofessional planning and simulation may be used to design a safe resuscitation plan incorporating US diagnosis of diaphragmatic anomalies into the Neonatal Resuscitation Program (NRP) algorithm.
期刊介绍:
Journal of Fetal Medicine is the official journal of the Society of Fetal Medicine affiliated with International Society of Ultrasound in Obstetrics & Gynecology. This is a peer-reviewed international journal featuring articles with special interest to fetal medicine specialists, geneticists and ulstrasonologists. The aim of the journal is to communicate the results of original research in the field of fetal medicine. It includes a variety of articles suitable for clinicians and scientific specialists concerned with diagnosis and therapy of fetal disorders. All articles on health promotion of the fetus are acceptable for publication. The major focus is on highlighting the work that has been carried out in India and other developing countries. It also includes articles written by experts from the West. Types of articles published: - Original research articles related to fetal care and basic research - Review articles - Consensus guidelines for diagnosis and treatment - Case reports - Images in Fetal Medicine - Brief communications