Echocardiographic measurements of normal fetal pulmonary artery and pulmonary branches and comparison on fetuses with congenital diaphragmatic hernia.

OBJECTIVE Congenital diaphragmatic hernia is one of the severe congenital pulmonary anomaly (PA) associated with pulmonary hypoplasia, pulmonary sequestration and severe respiratory distress. The aim of this study was to present difference between measurements of the size of fetal pulmonary artery and pulmonary branches (PB) in normal growth fetuses and comparison with the same in fetuses with congenital diaphragmatic hernia (CHD). Measurements were done by echocardiography. METHODOLOGY During the period March 2007 to March 2009 measurements were performed on a total of 115 normal fetuses, at 20-38 weeks gestation. By cross-sectional echocardiography were measured fetal PA and PB diameters. Retrospectively were reviewed 6 fetuses with left-sided CHD from 2005 to 2009. Measurements were done at level of the three vessel view (superior vena cava, ascending aorta and main PA). RESULTS Diameter of main PA and both branches were found to correlate with the advanced gestational age (r = 0.74, p < 0.01). There was calculated diameter of the left PB to main pulmonary artery ratio (LPB/MPA) and right PB to main pulmonary artery (RPB/MPA) ratio. These two parameters were almost constant throughout gestation. In all fetuses with CDH, LPB was normal or smaller than in normal fetuses. Both PB in compare with PMA were within the normal range in all normal fetuses. CONCLUSION Echocardiographic measurement of PB is an important method to establish the normal range of diameters of the PA branches and it appears to be useful to compare results on normal fetuses and fetuses with CDH and pulmonary hypoplasia.