What Is Your Diagnosis?

Abstract

Postnatal mortality and morbidity depends on the associated anomalies, on the position of the liver and on theremaining size of the lungs. With decre- asing volume of the lungs, the number of vessels and bronchioli decreases resulting in a hampered oxygenation and pulmonary hypertension.The chance of survival can be estimated by the lung to head ratio LHR and the respe- ctive observed to expected LHR o/e LHR . To compute the LHR, the area of the contralateral lung is divided by head circumference. In general, the ratio between the observed and expected LHR is used for counseling as this marker is independent from gestational age.In a series of 161 fetuses with isolated left sided CDH and intrathoratic liver herniation, about half of the neonates were discharged from hospital alive. The chance of postnatal survival was 258 × o/e LHR % −28,68 /100. In this registry there were also eight cases with isolated right sided CDH and none of the cases survived after birth. In cases with severe CDH o/e LHR < 25% , fetal endoscopic tracheal occlusion can be offered which may increase the survival rate 5 . References

Tanınız Nedır?

Abstract

References

1. McGivern MR, Best KE, RankinJ, Wellesley D, Greenlees R, Addor MC, et al. Epidemiology of congenital diaphragmatic hernia in Europe: a regis- ter-based study. Arch Dis Child Fetal Neonatal Ed. 2015; 100:137-44.
2. Grisaru-Granovsky S, Rabinowitz R, Ioscovich A, Elstein D, Schimmel MS. Congenital diaphragmatic hernia: review of the literature in reflection of unresolved dilemmas. Acta Pediatrica. 2009; 98: 1874-81.
3. Fisher JC, Jefferson RA, Arkovitz MS, Stolar CJ. Redefining outcomes in right congenital diaphragmatic hernia. J Pediatr Surg. 2008; 43: 373- 379.
4. Hedrick HL, Adzick NS. Congenital diaphragmatic hernia: Prenatal di- agnosis and management. www.uptodate.com, last updated on Feb 19,2015.
5. Jani JC, Nicolaides KH, Gratacós E, Valencia CM, Doné E, Martinez
6. JM, Gucciardo L, Cruz R, Deprest JA.Severe diaphragmatic hernia tre ated by fetal endoscopic tracheal occlusion.Ultrasound Obstet Gynecol. 2009;34:304-10.