Characterization of pulmonary arterial branching in rat fetuses with congenital diaphragmatic hernia

Congenital diaphragmatic hernia (CDH) is one of the congenital anomalies leading to neonatal deaths and postnatal respiratory disorders. When the abdominal organs herniate into the chest through the defect on the diaphragm, pulmonary hypoplasia and pulmonary hypertension might occur. Pulmonary hypoplasia is defined as the underdevelopment of the lung. On the other hand, pulmonary hypertension is defined as the increased pressure applied to the pulmonary artery wall due to the structural changes of the arteries. During the fetal period, the fetus gets oxygen through the placenta instead of using its own lungs. Although the pathology starts in utero, the pressure levels in the respiratory system could be measured postnatally. Even there are studies in the literature that aims to predict the severity of the disease in utero, none of them widely accepted. The methods used to estimate the degree of CDH include lung-to-head ratio, total lung volume, and the presence of a liver hernia. In this study, the data of rat fetuses gathered via micro-computed tomography were employed to compute the morphometric measurements of the pulmonary arteries and evaluated to predict the outcome of CDH. In future studies, new methods could be developed to assess the degree of the CDH anomaly in utero to help doctors with a surgical intervention decision.