Clinical outcomes and protocol for the management of isolated congenital diaphragmatic hernia based on our prenatal risk stratification system
| Autor: | Yoshiyuki Shimizu, Kazunori Masahata, Taku Yamamichi, Kazuya Tachibana, Muneyuki Takeuchi, Narutaka Mochizuki, Hideki Soh, Noriaki Usui, Jun Sasahara, Takatoshi Abe |
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| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Prenatal diagnosis Risk Assessment 03 medical and health sciences 0302 clinical medicine Pregnancy Prenatal Diagnosis 030225 pediatrics medicine Humans Retrospective Studies Fetus business.industry Study Type Significant difference Infant Newborn Infant Congenital diaphragmatic hernia Level iv General Medicine medicine.disease Treatment Outcome 030220 oncology & carcinogenesis Prenatal risk Pediatrics Perinatology and Child Health Female Surgery Hernias Diaphragmatic Congenital business Cohort study |
| Zdroj: | Journal of Pediatric Surgery. 55:1528-1534 |
| ISSN: | 0022-3468 |
| Popis: | The aim of this study was to evaluate our prenatal risk stratification system for risk-adjusted management in fetuses with isolated congenital diaphragmatic hernia (CDH).Ninety-four infants prenatally diagnosed with isolated CDH treated between 1998 and 2017 at our institution were included in this retrospective single-center cohort study.The patients were prenatally classified into four risk groups: Group A (n = 54), which consisted of infants with neither liver-up nor a contralateral lung-to-thorax transverse area (L/T) ratio0.08. The infants in group A were divided into two subgroups: Group A-1 (n = 24) consisted of mild conditions; and Group A-2 (n = 30) consisted of severe conditions; Group B (n = 23), which consisted of infants with either liver-up or L/T ratio0.08; and Group C (n = 17), which consisted of infants with both liver-up and L/T ratio0.08. The rates of survival to discharge in Groups A-1, A-2, B, and C were 100.0%, 100.0%, 87.0%, and 58.8%, respectively. The rates of intact discharge were 91.7%, 90.0%, 52.1%, and 23.5%, respectively.Our prenatal risk stratification system demonstrated a significant difference in the severity of postnatal status and clinical outcomes between the groups.Case Series, Retrospective Review.LEVEL IV. |
| Databáze: | OpenAIRE |
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