Perinatal Outcome in Congenital Diaphragmatic Hernia (CDH): A Single-Center Experience

Anubhuti Rana; K Aparna Sharma; Vivek Kumar; Priyanka Chaudhary; Anu Thukral; Sandeep Agarwala; Vatsla Dadhwal

doi:10.1007/s13224-023-01796-2

Perinatal Outcome in Congenital Diaphragmatic Hernia (CDH): A Single-Center Experience

J Obstet Gynaecol India. 2023 Oct;73(Suppl 1):37-42. doi: 10.1007/s13224-023-01796-2. Epub 2023 Aug 24.

Authors

Anubhuti Rana¹, K Aparna Sharma¹, Vivek Kumar², Priyanka Chaudhary¹, Anu Thukral², Sandeep Agarwala³, Vatsla Dadhwal¹

Affiliations

¹ Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
² Division of Neonatology, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India.
³ Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.

PMID: 37916008
PMCID: PMC10616035 (available on 2024-10-01)
DOI: 10.1007/s13224-023-01796-2

Abstract

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.

Keywords: Congenital diaphragmatic hernia; O/E LHR; Perinatal outcome; Pulmonary hypertension.

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