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Perinatal Outcome in Congenital Diaphragmatic Hernia (CDH): A Single-Center Experience
Anubhuti Rana1, K Aparna Sharma1, Vivek Kumar2
1Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Objective:
To study the perinatal outcome in fetuses diagnosed with congenital diaphragmatic hernia (CDH).
Methods:
Thirty-two pregnant women with antenatal diagnosis of CDH in fetus, who delivered between 2018 and 2021, were included in the study. Postnatally eventration of diaphragm was diagnosed in 3 neonates and were excluded.
Results:
The median gestational age at diagnosis was 23 weeks (IQR: 216-261 weeks). The mean O/E LHR was 34.88 ± 9.03%, and the O/E LHR was significantly lower in fetuses who did not survive (40.81 ± 4.25 vs 31.26 ± 9.33; p = 0.0037). On ROC analysis, at a cutoff of ≤ 32.93, O/E LHR had a specificity of 100% with a sensitivity of 72.22% in predicting mortality. Cases with liver herniation were not significantly different between survivors versus non-survivors. The overall survival rate was 37.93%, and the leading cause of death was severe persistent pulmonary hypertension.
Conclusion:
O/E LHR can predict mortality in neonates with antenatal diagnosis of CDH. The presence of pulmonary hypertension was the leading cause of death in these neonates.
