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Prognostic value of a hernia sac in congenital diaphragmatic hernia
Author(s) -
Spaggiari E.,
Stirnemann J.,
Bernard J.P.,
De Saint Blanquat L.,
Beaudoin S.,
Ville Y.
Publication year - 2013
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.11189
Subject(s) - medicine , congenital diaphragmatic hernia , hernia , autopsy , diaphragmatic hernia , surgery , fetus , prenatal diagnosis , pregnancy , biology , genetics
ABSTRACT Objective To investigate the prognostic value of a hernia sac in isolated congenital diaphragmatic hernia ( CDH ). Methods Our database was searched to identify all consecutive cases of CDH referred to our fetal medicine unit between January 2004 and August 2011. Presence or absence of a hernia sac was assessed in liveborn cases using surgery or postnatal autopsy reports. We studied the correlation between the presence of a hernia sac and prenatal findings and perinatal morbidity and mortality. Results Over the study period, there were 70 cases with isolated CDH born alive in which either a surgery or autopsy report was available. Neonatal death, either preoperative or postoperative, occurred in 1/18 (5.6%) infants with a hernia sac and in 17/52 (32.7%) cases without a hernia sac( P = 0.03). Patients with a hernia sac had a significantly higher observed to expected pulmonary volume on prenatal magnetic resonance imaging (51.9 vs 39.3%, P = 0.01). Neonatal morbidity in surviving infants was lower in the group with a hernia sac, although not significantly. Conclusion The presence of a hernia sac is associated with a higher pulmonary volume and a better overall prognosis for CDH . Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.