Texas Children’s Fetal Center staff has taken a closer look at fetal imaging, conducting three separate studies which evaluate the effectiveness and importance of diagnostic tools such as Fetal MRIs for identifying and treating CDH (congenital diaphragmatic hernia), EA (esophageal atresia) and MBA (mainstream bronchial atresia). The three studies were published in the Journal of Pediatric Surgery and confirm the significance of high quality imaging in the perinatal management of different congenital anomalies.
“These three studies show the importance of a correct and precise prenatal diagnosis using high technology and a multidisciplinary team of experts,” said Dr. Rodrigo Ruano, co-director of Texas Children’s Fetal Center and one of the authors on all three studies. “It is incredible that using fetal MRI, it is possible not only to determine if the fetus will survive or die, will need ECMO or not, but also if the fetus will have pulmonary morbidity and respiratory complications related to the congenital diaphragmatic hernia after birth in the NICU.”
In addition to identifying benefits of prenatal imaging, Ruano explains that a multidisciplinary approach – like the one that is used at Texas Children’s Fetal Center – also was shown to have significant benefits. For example, with the combination between excellent quality of prenatal imaging (ultrasound and MRI) and multidisciplinary expertise, one study showed that it was possible to identify prenatally the esophageal atresia in more than 80 percent of cases.
“We have fantastic opportunities to improve capabilities with the help of our imaging colleagues and following that all the way to the NICU and long term outcomes,” said Dr. Oluyinka Olutoye, co-director of the Texas Children’s Fetal Center and another co-author of the studies.
According to Olutoye, the studies will help fetal surgeons to better refine their ability to counsel patients, largely due to better predictors of outcomes.
“Our studies showed fascinating data that we now can predict with excellent accuracy the type of lung lesion (MBA instead of congenital adenomatoid malformation) as well as predicting respiratory morbidity related to CDH using fetal MRI and multidisciplinary evaluation,” said Ruano.
Ruano cites the improvement of quality in fetal imaging as one of the key improvements of fetal medicine over the past few years.