Congenital diaphragmatic hernia: Can prenatal ultrasonography predict outcome?
OBJECTIVE: We wanted to establish whether prenatal ultrasonography predicts postnatal outcome in congenital diaphragmatic hernia. STUDY DESIGN: We designed a retrospective multicenter cohort study of 135 patients with congenital diaphragmatic hernia (122 left, 10 right, 2 bilateral, 1 anterior). In...
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Veröffentlicht in: | American journal of obstetrics and gynecology 1996-04, Vol.174 (4), p.1377-1381 |
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Zusammenfassung: | OBJECTIVE: We wanted to establish whether prenatal ultrasonography predicts postnatal outcome in congenital diaphragmatic hernia.
STUDY DESIGN: We designed a retrospective multicenter cohort study of 135 patients with congenital diaphragmatic hernia (122 left, 10 right, 2 bilateral, 1 anterior). In isolated left congenital diaphragmatic hernia five potential prenatal prognostic factors were studied: diagnosis at ≤25 weeks' gestation, polyhydramnios, intrathoracic stomach, small abdomen, and major mediastinal shift.
RESULTS: None of the 44 fetuses or infants who had multiple malformations survived. Of the 91 cases of isolated congenital diaphragmatic hernia, there were 82 live births; 76 of these infants had a left congenital diaphragmatic hernia. Of these, 51 (67%) died postnatally. A statistically significant relation was found between mortality and polyhydramnios, intrathoracic stomach, and major mediastinal shift. Mortality increased as a function of the number of these prognostic factors from 20% when none was present to 94% when all three were present.
CONCLUSION: In the majority of cases of isolated left congenital diaphragmatic hernia the prognostic value of fetal ultrasonography is too low to alter perinatal management. (A
M J O
BSTET G
YNECOL 1996;174:1377-81.) |
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ISSN: | 0002-9378 1097-6868 |
DOI: | 10.1016/S0002-9378(96)70688-9 |