Abstract

Aim: Intrathoracic position of the stomach, mediastinal shift, polyhidroamnious as individual variables and early gestation of 25 weeks reveal to be poor prenatal ultrasonographic predictors for outcome of Congenital Diaphragmatic Hernia (CDH).

The aim of the study was to determine treatment outcomes of our patients with CDH and evaluate the role of prenata diagnosis on outcome.

Material and Methods: We retrospectively reviewed the records of 26 newborns with left CDH seen between January 2004 and September 2006 with follow up ranging 32 months period. Results of treatment in these newborns were analyzed in regard to gender, existence of the prenatal diagnosis, gestational age at diagnosis, type of delivery, postnatal treatment modalities, operating time, operational findings, associated anomalies, mortality rate and outcomes.

Results: There were total of 26 newborns, 13 had got prenatal diagnosed left CDH. All of them presented with respiratory distress within the first 24 hours after delivery and all required mechanical ventilation. 10 of 26 neonates with CDH died within the first hours under the medical treatment, 8 of these 10 neonates had got prenatal diagnosed. 9 of 16 operated cases were died within the 48 hours after the operation, 4 of these 9 operated cases had prenatal diagnosis, 3 of died patients had got complete left diaphragmatic agenesis. 7 of 16 operated cases of CDH had been alive, only one of them had got prenatal diagnosed. Mortality rate were found 73% in total patients, only one case of 13 cases had survived in prenatal diagnosed group.

Conclusion: Despite intensive clinical and experimental efforts mortality rate of CDH remains high. Making of the prenatal diagnosis of the CDH demonstrates no change of mortality rate in our series. Prenatal intervention programming in the treatment of the fetus with CDH must be plan in near future.