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Congenital diaphragmatic hernia has a better prognosis when associated with a hernia sac
Author(s) -
Bouchghoul Hanane,
Marty Oriane,
Fouquet Virginie,
Cordier AnneGaël,
Senat MarieVictoire,
Saada Julien,
Mokhtari Mostafa,
Le Sache Nolwenn,
Martinovic Jelena,
Benachi Alexandra
Publication year - 2018
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.5326
Subject(s) - congenital diaphragmatic hernia , medicine , hernia , surgery , diaphragmatic hernia , prenatal diagnosis , fetus , pregnancy , genetics , biology
Objective To evaluate neonatal mortality and morbidity up to 6 months in neonates with congenital diaphragmatic hernia (CDH) with or without a hernia sac. Methods Seventy‐two cases of isolated CDH were included in a retrospective single‐center study between January 2010 and December 2016. Hernia sac was defined at the time of surgery or at postmortem examination if the neonate died before surgery. Results Seventeen newborns (23.6%) had a hernia sac. Survival at 6 months was significantly greater for isolated CDH with a hernia sac: 100% versus 63.6% ( P = .003). High‐frequency oscillatory ventilation was used significantly more in the no hernia sac group ( P = .04). At surgery, the need for patch repair was significantly lower in the hernia sac group: 12% versus 50% ( P = .005). The prenatal observed/expected lung‐to‐head ratio was significantly higher in the hernia sac group than in the no hernia sac group: 49.7% versus 38.6% ( P < .05). Conclusion The presence of a hernia sac in CDH is associated with better outcome, especially survival at 6 months. If the presence of a hernia sac is recognized as a particular entity, which carries a good prognosis, it is necessary to be able to diagnose it prenatally, especially in the era of prenatal fetal surgery.