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Associated anomalies in congenital diaphragmatic hernia: perinatal characteristics and impact on postnatal survival

Nobuhiro Hidaka, Keisuke Ishii, Aki Mabuchi

    Journal of Perinatal Medicine
    |July 12, 2014
    PubMed

    Insights

    Congenital diaphragmatic hernia (CDH) with additional anomalies indicates a poor prognosis. However, intrathoracic liver presence and lung-to-thorax ratio (LTR) can help predict outcomes in complex CDH cases.

    Area of Science:

    • Perinatal medicine
    • Fetal surgery
    • Pediatric surgery

    Background:

    • Congenital diaphragmatic hernia (CDH) is a serious birth defect.
    • Understanding factors influencing CDH prognosis is crucial for clinical management.

    Purpose of the Study:

    • To investigate clinical characteristics and postnatal outcomes of fetuses with CDH.
    • To compare outcomes between isolated CDH and CDH with additional anomalies (complex CDH).

    Main Methods:

    • Retrospective chart review of fetuses with CDH (2005-2013).
    • Classification into isolated and complex CDH groups.
    • Analysis of polyhydramnios, liver herniation, stomach position, and lung-to-thorax transverse area ratio (LTR).

    Main Results:

    • 23 of 65 fetuses had complex CDH.
    • Complex CDH showed higher rates of liver herniation, polyhydramnios, and mortality, with lower LTR.
    • Lower mortality was observed with LTR <0.08 in complex CDH.
    • Intrathoracic liver presence correlated with lower survival rates.

    Conclusions:

    • Complex CDH has a poor prognosis, influenced by associated anomalies and CDH severity.
    • Intrathoracic liver and LTR are valuable prognostic indicators in complex CDH.
    • These indicators aid in estimating postnatal outcomes for fetuses with CDH.
    Abstract

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