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Outcome of congenital diaphragmatic hernia

M W Beresford1, N J Shaw

  • 1Regional Neonatal Unit, Liverpool Women's Hospital, Liverpool, UK.

Pediatric Pulmonology
|September 6, 2000
PubMed

Insights

Congenital diaphragmatic hernia (CDH) outcomes vary by diagnosis timing and presence of other anomalies. This review offers clinicians data to guide parents on CDH prognosis.

Area of Science:

  • Pediatric Surgery
  • Neonatology
  • Medical Research

Background:

  • Congenital diaphragmatic hernia (CDH) presents varied outcomes based on developmental stage.
  • Assessing combined data from nonrandomized studies on CDH is challenging.
  • Accurate prognosis is crucial for parental counseling in CDH cases.

Purpose of the Study:

  • To systematically review the literature on congenital diaphragmatic hernia (CDH) outcomes.
  • To provide clinicians with a guide for counseling parents of fetuses/infants with CDH.
  • To analyze mortality rates across different CDH diagnostic and treatment stages.

Main Methods:

  • Systematic review of 35 studies on CDH outcomes from 1985 to March 1998.
  • Utilized a high-sensitivity search strategy, journal hand-searching, and reference reviews.
  • Analyzed data based on antenatal diagnosis, live birth, and postoperative stages.

Main Results:

  • Overall median mortality for CDH was 58% if diagnosed in utero, 48% if born alive, and 33% postoperatively.
  • Diagnosis before 25 weeks gestation had a median mortality of 60%; other anomalies increased mortality to 93%.
  • Median mortality in extracorporeal membrane oxygenation (ECMO) centers was 34% for live-born infants and 44% for all ECMO-treated infants.

Conclusions:

  • Mortality in congenital diaphragmatic hernia (CDH) is significantly influenced by diagnostic timing, gestational age, presence of other anomalies, and treatment strategies.
  • Extracorporeal membrane oxygenation (ECMO) appears to reduce mortality in treated infants.
  • This review provides essential data for improving parental counseling regarding CDH prognosis.

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