Outcome of Congenital Diaphragmatic Hernia: A Single Center Experience

Jayasree Chandramati,Naveen Viswanathan,Sasidharan Ponthenkandath,Mohan Abraham,Ashwin Prabhu,Smriti M Menon,Lakshmi S Nair

doi:10.47338/jns.v8.354

Abstract

Background: Congenital diaphragmatic hernia (CDH) is a complex malformation with a challenging perioperative care. The outcome is still not very impressive in developing countries despite its remarkable improvement in developed countries.Methods: We analyzed outcomes, and factors associated with morbidity and mortality of 120 newborns with CDH, managed at our institution.Results: The overall survival was 73.4%. Chromosomal aberrations, pneumothorax within 24 hours, left ventricular hypoplasia, biventricular dysfunction, fetal lung to head ratio (LHR)Conclusion: This is the largest series of a retrospective cohort study of CDH reported in India. We have briefly reviewed the topic and the management guidelines along with prognostic markers derived from this study.

Highlights

Congenital diaphragmatic hernia (CDH) is a major congenital malformation with an incidence of approximately one in 2500-3000 deliveries.[1]
In this single center study, we have reviewed the outcome of newborns with CDH and attempted to identify predictors of outcome in our cohort
Data of 120 newborns with CDH admitted to the NICU at Amrita Institute of Medical Sciences, from 2013 to 2018 was reviewed for gestational age, birthweight, associated congenital anomalies, APGAR scores, antenatal diagnosis including lung to head ratio (LHR) and position of liver, initial pH, use of vasopressors, echocardiographic findings, ventilatory modality, age at surgery, presence of pneumothorax, surgery, length of stay of survivors, time of death, sepsis, and persistent pulmonary hypertension

Summary

Introduction

Congenital diaphragmatic hernia (CDH) is a major congenital malformation with an incidence of approximately one in 2500-3000 deliveries.[1] The outcome has significantly improved owing to advances in the management. Therapeutic principles have changed from early surgery to pre-surgery hemodynamic stabilization with better understanding of the fetal lung parenchymal and vascular development.[2] Several variable predictors of poor outcome have been identified in various studies.[39]. In this single center study, we have reviewed the outcome of newborns with CDH and attempted to identify predictors of outcome in our cohort. We have briefly reviewed the topic and the management guidelines along with prognostic markers derived from this study

Methods

Results

Discussion

Conclusion