Causes of death in operated neonates with diaphragmatic defects

The causes for the high mortality in neonates with diaphragmatic hernia are manifold. These cases have to be classified as being in the "fatal zone" of Boix-Ochoa. Analysis of our patients showed that 27 patients belonged to this group, 15 of whom died. The causes of death were hypoplasia of both lungs in 1 case and intracranial haemorrhage in 1. In 6 neonates there were additional complex cardiac malformations and in 1 other severe malformations. The foetal circulation persisted in 3 infants and a tension pneumothorax was the cause in 2, an intestinal obstruction the cause of death in 1 infant. In these 5 last-mentioned children, improvements in treatment might have possibly prevented death.