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Congenital diaphragmatic hernia: Impact of contemporary management strategies on perinatal outcomes
Author(s) -
Lee HanShin,
Dickinson Jan E.,
Tan Jason KG,
Nembhard Wendy,
Bower Carol
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.5376
Subject(s) - medicine , congenital diaphragmatic hernia , pregnancy , concomitant , retrospective cohort study , obstetrics , pediatrics , live birth , diaphragmatic hernia , medical record , perinatal mortality , survival rate , hernia , fetus , surgery , genetics , biology
Objective This study aims to review temporal changes in perinatal management and 1‐year survival outcomes of cases of congenital diaphragmatic hernia (CDH) from 1996 to 2015 in Western Australia (WA). Method This research is a retrospective study of all cases of CDH in WA from 1996 to 2015 identified from five independent databases within the WA health network. Detailed information pertaining to pregnancy and survival outcomes were obtained from review of maternal and infant medical records. Results There were 215 cases of CDH with 164 diagnosed prenatally. Between 1996 and 2010, a decline in live birth rates for CDH‐affected pregnancies was observed, reaching a nadir of 5.3 per 10 000 births before increasing to a peak of 9.73 per 10 000 births in 2011‐2015. A corresponding decline was seen in the number of pregnancies terminated in the same period from 8.3 to 4.6 per 10 000 births ( P = 0.14) and an increase in survival of live births from 38.9% to 81.3% ( P = 0.01). Conclusion The improved overall survival rate in infants with CDH over the last 20 years may have resulted in an increased tendency for women to continue their pregnancy with a concomitant decline in termination rates. Information from this study will help in the counselling of women following prenatal detection of CDH.