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Perinatal outcome and prognostic factors in prenatally diagnosed congenital diaphragmatic hernia
Author(s) -
Geary M. P.,
Chitty L. S.,
Morrison J. J.,
Wright V.,
Pierro A.,
Rodeck C. H.
Publication year - 1998
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 - 10.1046/j.1469-0705.1998.12020107.x
Subject(s) - medicine , congenital diaphragmatic hernia , diaphragmatic hernia , prenatal diagnosis , hernia , survival rate , diaphragmatic breathing , pregnancy , obstetrics and gynaecology , fetus , obstetrics , surgery , pediatrics , pathology , genetics , alternative medicine , biology
Objective The purpose of this study was to assess perinatal outcome in cases of prenatally diagnosed congenital diaphragmatic hernia and identify the prognostic value of various prenatal factors. Design Retrospective review of fetal medicine, obstetric and histopathology records in all 34 cases of congenital diaphragmatic hernia identified prenatally between 1992 and 1996 at a tertiary referral fetal medicine unit. Results Overall survival was 18%. None of those with bilateral (0/1) or right‐sided (0/5) congenital diaphragmatic hernia survived, whereas 21% (6/28) of those with left‐sided hernias survived. Prenatal karyotyping was performed in 71% ( n = 24) and five chromosomal abnormalities were identified. The pregnancy was terminated in 15 cases (44%). In the 19 continuing pregnancies, the survival rate was 32% (6/19). In those with an isolated congenital diaphragmatic hernia, the survival rate was 38% (5/13), and in those in which the hernia was isolated and left‐sided, the survival rate was 56% (5/9). In ongoing pregnancies diagnosed after 24 weeks, the survival rate was 33% (2/6) compared with 31% (4/13) in pregnancies diagnosed at ≤ 24 weeks. Of those infants who had surgical repair, six out of seven (86%) survived. Conclusions These data clearly demonstrate an improved prognosis in fetuses with an isolated left‐sided congenital diaphragmatic hernia. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology