Study of a Typical Presentations in Congenital Diaphragmatic Hernia

Poondla, Venkata Ramana; Kothakoona, Srilakshmi; J, Rao K V; K, Kameswari

doi:10.14260/jemds/2015/2059

Cited by 2 publications

(7 citation statements)

References 8 publications

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“…A female predominance for a Bochdalek hernia observed by some authors has been well documented; however, others have observed a male predominance. [ 5 ] In our study also male preponderance was seen.…”

Section: Discussionsupporting

confidence: 75%

“…Most are detected after 24 weeks of gestation. [ 3 5 ] Earlier detection is associated with increased mortality but not reported in all the studies. [ 4 5 ] However, prenatal detection of CDH is rare in developing countries due to inadequate facilities.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 5 ] Earlier detection is associated with increased mortality but not reported in all the studies. [ 4 5 ] However, prenatal detection of CDH is rare in developing countries due to inadequate facilities. [ 5 ] In our cohort 17/83 (20%) of the cases were diagnosed prenatally; most were detected at 35 weeks, only before delivery.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 5 ] However, prenatal detection of CDH is rare in developing countries due to inadequate facilities. [ 5 ] In our cohort 17/83 (20%) of the cases were diagnosed prenatally; most were detected at 35 weeks, only before delivery. Polyhydramnios has been reported up to 80% of CDH cases.…”

Section: Discussionmentioning

confidence: 99%

“…CDH is usually diagnosed immediately after birth with respiratory distress, scaphoid abdomen, bowel sounds in the chest, and mediastinal shift on chest X-ray. [ 4 5 6 7 8 ]…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

A clinical study on congenital diaphragmatic hernia in neonates: Our institutional experience

Aihole¹,

Gowdra²,

Deepak³

et al. 2018

J Indian Assoc Pediatr Surg

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Background:Congenital diaphragmatic hernia (CDH) is a complex developmental defect having a multifactorial etiology; i majority of cases (~80%), the cause is not known. Survival rates for patients with CDH have increased over the past decade with early prenatal detection and better postnatal management including surgery. Clinical profile and the outcome of 83 CDH neonates were studied and analyzed over a period of 12 years in our institute.Aims and Objectives:The clinical study was to analyze the clinical profile and outcome of CDH among the neonates in a tertiary care referral neonatal and pediatric center in Karnataka, India.Materials and Methods:This was a retrospective and prospective observational study conducted from January 2005 to March 2017, over a period of 12 years in a tertiary care referral neonatal and pediatric center in southern India. Clinical characteristics and risk factors of 83 neonates admitted and diagnosed with CDH were compared between survivors and nonsurvivors both preoperatively and postoperatively. Neonates with clinical and intraoperative diagnosis of diaphragmatic eventration were not included in this study. Multivariate logistic regression analysis was performed to determine independent predictors for mortality.Results:A total of 83 neonates admitted and diagnosed with CDH were included in this study; 73 of them underwent surgical repair. The total survival rate in neonates with CDH was 70/83 (84.33%) and the overall operative mortality was 3/73 (4.1%). There was a significant difference between CDH neonates who survived 70/83 (84.33%) and those who died 13/83 (15.67%), in the age on admission, 5 min Apgar score, onset of respiratory distress, preoperative ventilation, the presence of persistent pulmonary hypertension of the newborn (PPHN), high-frequency oscillatory ventilation (HFOV), and length of hospital stay with P < 0.05. Using multivariate logistic regression analysis, the following factors independently predicted mortality: onset of respiratory distress in hours (odds ratio: 0.5, 95% confidence interval: 0.37–0.82) and preoperative ventilation (odds ratio: 0.02; 95% confidence interval: 0.0028–0.1558). When we compared CDH neonates who survived after surgery (n = 70) with those who expired (n = 3) postoperatively, there was a significant difference in the gestational age in weeks, side of CDH, PPHN, HFOV and length of hospital stay with P < 0.05.Conclusion:CDHs are common on the left side with fairly good prognosis. Though, the right-sided CDH are rare; they do carry a good prognosis, as it was seen in our experience.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…CDH is usually diagnosed immediately after birth with respiratory distress, scaphoid abdomen, bowel sounds in the chest, and mediastinal shift on chest X-ray. [ 4 5 6 7 8 ]…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

A clinical study on congenital diaphragmatic hernia in neonates: Our institutional experience

Aihole¹,

Gowdra²,

Deepak³

et al. 2018

J Indian Assoc Pediatr Surg

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Right Bochdalek congenital diaphragmatic hernia: a tertiary center’s experience over 13 years

Alghamdi

Raboe

2021

Ann Pediatr Surg

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Background Right Bochdalek congenital diaphragmatic hernia (RB-CDH) is far less common than left Bochdalek congenital diaphragmatic hernia, accounting for only 13% of cases. There are limited published data on the outcomes and survival rate of RB-CDH. We aimed at investigating the clinical characteristics and analyzing the risk factors of survival in neonates with RB-CDH treated in our center over a period of 13 years. Results Fifteen infants with RB-CDH were identified. Most of the patients were full term (74%). The mean birth weight was 2.90± 0.72 kg. The ratio of male to female was 2:1. The mean APGAR score at 1 min was 5.31±2.34, and 7.30±1.59 at 5 min. Ten patients (67%) were imaged by antenatal ultrasound. Eleven patients (73.33%) survived to go for surgical repair. The hernia sac was found in 5 patients (45%). Most hernial defects were closed in a primary fashion. The mean age at the operative repair was 8.11±9.90 days. The average NICU stay for all patients was 40.47±50.38 days. The mean follow-up period was 20.45±9.34 months. Three patients had postoperative complications. The total survival rate in neonates with RB-CDH was 9/15 (60%). Nine out of 11 (82%) neonates survived after surgical repair. Four patients (27%) died before surgical repair. Ventilation-related bilateral pneumothorax was a contributing cause of death in three patients. Birth weight was found lower in the non-survivor’s group (P < 0.05). Moreover, the degree of pulmonary hypertension was more severe among non-survivors. No statistical significance was observed between other variables and mortality. Conclusion We found that low birth weight and the presence of severe PHTN were risk factors for mortality in neonates with RB-CDH. These results are in line with previous studies on prognostic factors in CDH. Ventilator-related pneumothorax appears to be a significant contributing cause of death. Long-term follow-up studies of infants born with RB-CDH are needed as small number of cases limits large-volume RB-CDH studies.

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Study of a Typical Presentations in Congenital Diaphragmatic Hernia

Cited by 2 publications

References 8 publications

A clinical study on congenital diaphragmatic hernia in neonates: Our institutional experience

A clinical study on congenital diaphragmatic hernia in neonates: Our institutional experience

Right Bochdalek congenital diaphragmatic hernia: a tertiary center’s experience over 13 years

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