Is it Possible to Predict Survival in Cases with Congenital Diaphragmatic Hernia?

INTRODUCTION: This study was planned to determine whether there is a correlation between diagnosis criteria and survival and morbidity rates and to
show the importance of blood gas values taken in the first 24 hours with a view to prognostic survival predictions in newborns with CDH treated and followed at our department.
METHODS: This study was carried out prospectively covering newborns with CDH treated and followed between January 2006 and May 2009.
For the gathering of data; demographic features, diagnostic time (prenatal/postnatal), all findings of laboratory and radiology, treatment characteristics, early stage post-operative complications, and results were evaluated.
RESULTS: 37 newborn with congenital diaphragmatic hernia were hospitalized, followed and treated at our department during 29 months period. 18 were female (48.6%) and 19 were male (51.4%). Prenatal diagnosis was made in 30.3%. Ultrasonography showed polyhydramnios in 5 out of 15 cases (41.6%) diagnosed prenatally and polyhydramnios with intrathoracic stomach in 3 cases (25.1%).
Spontaneous delivery was happened in 54.5%. Hernia was on the left side in 72.7% of the patients, and 21.7% of patients had involved major anomalies. The difference between dying and surviving cases was found statistically significant according to 1st
and 5th minute APGAR scores, and MAP, VI, MVI, OI, PIP values, and existence of major anomalies.
DISCUSSION AND CONCLUSION: This study demonstrated that the prenatal diagnosis before 25th week, existence of major anomalies, 1st and 5th minute APGAR scores, PIP, OI and MVI values may be used in order to make a prediction as a prognostic factor in cases with CDH. Although statistically significant relationship between the mortality rate and polyhydramnios and/or prenatal diagnosis and survive were not significantly; lower than 40 of the MVI was found to be helpful in positive predicting on survival of cases with CDH.