Early population-based outcomes of infants born with congenital diaphragmatic hernia

Abstract

This is the first British Isles population-based study reporting outcome metrics for infants born with CDH. 16% of babies did not survive to undergo surgery. Factors associated with poor outcome included female sex and prenatal diagnosis. Early postoperative survival in those who underwent surgical repair was excellent.

Congenital diaphragmatic hernia: Impact of contemporary management strategies on perinatal outcomes

“…For pregnancies with an antenatal diagnosis of CDH, 62.8% resulted in a live birth, with 73% of these surviving to surgery and a 91% postsurgery survival in the absence of prenatal fetal therapy such as fetoscopic tracheal occlusion (FETO). This is akin to the results from population‐based studies on CDH in the United Kingdom and France . In Western Australia, terminations of pregnancy are permitted on request or when the life, physical, or mental health of the woman is endangered, up to 20 weeks gestation.…”

“…This is akin to the results from population-based studies on CDH in the United Kingdom and France. 13,24,27,28 In Western Australia, terminations of pregnancy are nates with CDH in the mid-1990s. 35 Since then, there has been a progressive improvement in survival [36][37][38] and decreased need for ECMO.…”

Challenge of determining true outcome of congenital diaphragmatic hernia

“…Multidisciplinary counselling involves informing the expectant parents of the condition, together with the risks and available treatment options as well as the short-term prognosis and long-term issues. In the cohort reported by Long et al ,1 only 78% of expectant parents received counselling by a surgeon. Assuming some families in the UKOSS study opted for termination after diagnosis, it would be interesting to know what information was provided to them and by whom.…”

“…Such studies would aid parental counselling, guide therapy and provide benchmarking data for clinicians and centres. The paper by Long et al 1 is a valuable contribution to the current evidence base, but we must be cautious in interpreting the presented data as true population outcomes.…”

Does the Presence of a Hernia Sac Improve Survival in Newborns with Congenital Diaphragmatic Hernia? A United Kingdom Single-Center Experience

“…3 Antenatal diagnosis in $50 to 70% of CDH permits parental prenatal counseling, planning of fetal interventions, timing of delivery, and planned intubation at delivery to avoid gaseous distension of herniated bowel loops. 3,5,6 The innovation, clinical implementation, and adoption of antenatal strategies such as fetal endoscopic tracheal occlusion Introduction A developing body of literature suggests that the presence of a hernia sac in fetuses with congenital diaphragmatic hernia (CDH) may indicate improved prognosis. By examining a large cohort of CDH newborns admitted to a single United Kingdom specialist center, we aimed to establish if presence of hernia sac is a robust predictor of improved survival.…”