Outcomes of congenital diaphragmatic hernia: a 12-year experience.

Autor: Samangaya RA; Fetal Medicine Unit, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK. Rebekah.samangaya@cmft.nhs.uk, Choudhri S, Murphy F, Zaidi T, Gillham JC, Morabito A
Jazyk: angličtina
Zdroj: Prenatal diagnosis [Prenat Diagn] 2012 Jun; Vol. 32 (6), pp. 523-9. Date of Electronic Publication: 2012 Apr 13.
DOI: 10.1002/pd.3841
Abstrakt: Objective: To determine outcomes for babies with congenital diaphragmatic hernia (CDH) diagnosed prenatally and postnatally presenting to a tertiary unit.
Method: Fetal medicine database and neonatal surgical unit admission books were reviewed to identify cases of CDH over a 12-year period (Jan 1998- Dec 2009).
Results: A total of 132 cases of CDH were diagnosed prenatally and 39 cases diagnosed postnatally. Mean gestation at diagnosis was 22 weeks (range 13-37 weeks). Karyotyping was abnormal in 15.9%; abnormal karyotype in 3.6% of fetuses without other structural anomalies compared with 38.9% when other anomalies were identified. In 45 cases (34.1%) pregnancy was terminated. Two stillbirths occurred (2.3% of ongoing pregnancies). One hundred twenty-four babies were live born, of whom 98 babies underwent surgery. Survival to discharge of all live born babies was 72.6%; survival following surgery was 91.8%. Birthweight had a significant effect on survival (odds ratio 0.22, 95% confidence intervals 0.08-0.66). Survival for live born babies prenatally diagnosed was significantly lower (65.9%) than those diagnosed postnatally (92.3%).
Conclusion: Abnormal karyotype was more common when CDH was associated with other anomalies. In multivariate analysis, lower birthweight and prenatal diagnosis had a significant impact on survival. Only prenatally diagnosed CDH survival figures should be utilised in prenatal counselling.
(© 2012 John Wiley & Sons, Ltd.)
Databáze: MEDLINE
Externí odkaz: