OC269: Prenatal prediction of neonatal morbidity in congenital diaphragmatic hernia: a multicenter study

Abstract

Objectives: The fetal lung area to head circumference ratio and position of the liver are predictors of survival in isolated CDH. We aimed to investigate the value of the observed/expected LHR (o/e LHR) and position of the liver in the prediction of neonatal morbidity in survivors with congenital diaphragmatic hernia (CDH). Methods: Neonatal morbidity was recorded in 100 consecutive cases with prenatally diagnosed isolated CDH, who were expectantly managed in the prenatal period, were delivered after 30 weeks and survived until discharge from the hospital. Regression analysis was used to identify the significant predictors of morbidity, including prenatal and immediate neonatal findings. Results: The o/e LHR was the main significant predictor of the need for prosthetic patch repair, duration of assisted ventilation, need for supplemental oxygen at 28 days, and incidence of feeding problems. An additional independent prenatal predictor of the need for patch repair was the presence of fetal liver in the chest. Conclusions: In isolated CDH the prenatally assessed size of the contralateral lung is a significant predictor of the need for prosthetic patch repair, the functional consequences of impaired lung development and occurrence of feeding problems.