Congenital Diaphragmatic Hernia in a Developing Country

Bhat, YR and Kumar, V and Rao, A (2008) Congenital Diaphragmatic Hernia in a Developing Country. Singapore Medical Journal, 49 (9). pp. 715-718.

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Introduction: Outcome of neonates with congenital diaphragmatic hernia (CDH) varies widely and the data from developing countries is scanty. We aimed to study the management and outcome of CDH. We also aimed to ascertain prenatal and ostnatal factors affecting the outcome. Methods: A retrospective review of neonates with CDH admitted to a teaching ospital was conducted. Demographical data, prenatal and postnatal factors, birth details, management and outcomes were studied. Survival was the primary outcome. Results: 16 live-born neonates with diaphragmatic hernia were admitted during the study period. All neonates had hernia on the left side. Mean (standard deviation) gestational age and birth weight were 38.6 (1.5) weeks and 2,616.6 (457) g, respectively. Polyhydramnios was associated in one patient, and additional anomalies in five patients (31.3 percent). Overall survival was 56.3 percent. The CDH was detected renatally in four and postnatally in 12 patients. 12 neonates underwent surgery and nine survived. Prenatallydetected cases had significantly reduced survival to surgery, overall survival and lower Apgar scores at one minute (p-value is less than 0.04). Median age at surgery was 48 hours. Average duration of mechanical ventilation among survivors was 91.5 hours. Neonatal intensive care unit stay ranged from five to 27 (median nine) days. Six of seven deaths occurred within 72 hours of life. Nonsurvivors had significantly low Apgar scores and were symptomatic within 12 hours of life (p-value is less than 0.03). Conclusion: Greater than 50 percent survival of neonates with CDH was observed in a centre with conventional ventilation. Poor outcome is likely in neonates who present within 12 hours of life.

Item Type: Article
Uncontrolled Keywords: Congenital diaphragmatic hernia, Neonatal hernia, Neonatal survival
Subjects: Medicine > KMC Manipal > Paediatrics
Medicine > KMC Manipal > Surgery
Depositing User: KMC Manipal
Date Deposited: 20 Feb 2012 10:16
Last Modified: 20 Feb 2012 10:16

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