Premium
Outcomes of congenital diaphragmatic hernia: a 12‐year experience
Author(s) -
Samangaya Rebekah A.,
Choudhri Safiyya,
Murphy Fiona,
Zaidi Taqui,
Gillham Joanna C.,
Morabito Antonino
Publication year - 2012
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.3841
Subject(s) - medicine , congenital diaphragmatic hernia , prenatal diagnosis , odds ratio , diaphragmatic hernia , pregnancy , pediatrics , gestation , fetus , obstetrics , confidence interval , hernia , surgery , genetics , biology
Objective To determine outcomes for babies with congenital diaphragmatic hernia (CDH) diagnosed prenatally and postnatally presenting to a tertiary unit. Method Fetal medicine database and neonatal surgical unit admission books were reviewed to identify cases of CDH over a 12‐year period (Jan 1998– Dec 2009). Results A total of 132 cases of CDH were diagnosed prenatally and 39 cases diagnosed postnatally. Mean gestation at diagnosis was 22 weeks (range 13–37 weeks). Karyotyping was abnormal in 15.9%; abnormal karyotype in 3.6% of fetuses without other structural anomalies compared with 38.9% when other anomalies were identified. In 45 cases (34.1%) pregnancy was terminated. Two stillbirths occurred (2.3% of ongoing pregnancies). One hundred twenty‐four babies were live born, of whom 98 babies underwent surgery. Survival to discharge of all live born babies was 72.6%; survival following surgery was 91.8%. Birthweight had a significant effect on survival (odds ratio 0.22, 95% confidence intervals 0.08–0.66). Survival for live born babies prenatally diagnosed was significantly lower (65.9%) than those diagnosed postnatally (92.3%). Conclusion Abnormal karyotype was more common when CDH was associated with other anomalies. In multivariate analysis, lower birthweight and prenatal diagnosis had a significant impact on survival. Only prenatally diagnosed CDH survival figures should be utilised in prenatal counselling. © 2012 John Wiley & Sons, Ltd.