Anubhuti Rana, K. Aparna Sharma, Vivek Kumar, Priyanka Chaudhary, Anu Thukral, Sandeep Agarwala, Vatsla Dadhwal
All India Institute of Medical Sciences.
India
Journal of Obstetrics and Gynaecology of India
J Obstet Gynaecol India 2023; 73(Suppl 1): 37-42
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.
Category
Class III. Pulmonary Hypertension Associated with Lung Hypoplasia
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
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