Abstract
Background: The outcome of congenital diaphragmatic hernia depends on associated anomalies, degree of pulmonary hypoplasia, and hypertension. We evaluated the postnatal prognostic factors which can be used to predict the outcome.Methods: This study was conducted at a tertiary center (Vali-e-Asr Hospital, Imam Khomeini Complex, Tehran, Iran) during 2013-2019. The predictors of survival were evaluated.Results: A total of 49 infants with congenital diaphragmatic hernia were born during 2013-2019. The patients’ mean gestational age and weight at birth were 37.51±1.75 weeks and 2871±562 g, respectively. The mortality rate in patients with surgery (n = 41) was 31.3% and eight patients died before surgery. Mortality had significant relationships with five-minute Apgar score, peak inspiratory pressure before and after surgery, partial pressure of arterial oxygen (PaO2), and pH during first 24 hours after birth (p= 0.01, 0.001, and 0.01, respectively). The predicted and true survival rates in the patients were 66% and 52%, respectively (p= 0.001).Conclusion: Predicting survival rate after birth is remarkable but controversial. This estimate should not affect patient care and should only help parents in the process of decision-making.
Highlights
The survival of children with congenital diaphragmatic hernia (CDH) has steadily improved to 70%-90% over the past decades because of increased application of standardized protocols and gentle ventilation strategies, including permissive hypercarbia, high-frequency ventilation, inhaled nitric oxide, and extracorporeal membrane oxygenation (ECMO).[4,8]
The Congenital Diaphragmatic Hernia Study Group (CDHSG) has developed models to predict postnatal outcomes based on one- and five-minute Apgar scores
According to the formula recommended by the CDHSG in 2001, [11] the predicted survival rate was 61% in patients who underwent surgery
Summary
The prevalence of congenital diaphragmatic hernia (CDH) is approximately one in 2500-4000 live births.[1,2,3] The severity of the disease and final outcome are variable and depend upon comorbidities and the degree of associated pulmonary hypoplasia and pulmonary hypertension.[4,5] Other determinants of disease severity are the side of hernia, the position of the liver, the amniotic fluid volume, lung parameters (e.g. lung to head circumference ratio), central nervous system defects, complex syndromes, and chromosomal defects.[6,7]. The Congenital Diaphragmatic Hernia Study Group (CDHSG) has developed models to predict postnatal outcomes based on one- and five-minute Apgar scores. Natal survival.[7,10,11] The present study was conducted to compare the survival rates predicted by the above-mentioned methods with true survival rates
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
