The Japanese experience with prenatally diagnosed congenital diaphragmatic hernia based on a multi-institutional review

Hiroomi Okuyama, Yoshihiro Kitano, Mari Saito, Noriaki Usui, Nobuyuki Morikawa, Kouji Masumoto, Hajime Takayasu, Tomoo Nakamura, Hiroshi Ishikawa, Motoyoshi Kawataki, Satoshi Hayashi, Noboru Inamura, Keisuke Nose, Haruhiko Sago

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Purpose: To review the recent Japanese experience with prenatally diagnosed congenital diaphragmatic hernia (CDH) based on a multi-institutional survey. Methods: A multicenter, retrospective cohort study was conducted on 117 patients born between 2002 and 2007 with isolated prenatally diagnosed CDH. All patients were managed by maternal transport, planned delivery, immediate resuscitation and gentle ventilation. The primary outcome measurements were the 90-day survival and intact discharge. The examined prenatal factors included gestational age (GA) at diagnosis, lung-to-head ratio (LHR), lung-to-thorax transverse area ratio (L/T) and liver position. Physical growth and motor/speech development were evaluated at 1.5 and 3 years of age. Data were expressed as the median (range). Results: The mean GA at diagnosis was 29 (17-40) weeks. The LHR and L/T were 1.56 (0.37-4.23) and 0.11 (0.04-0.25), respectively. There were 48 patients with liver up. The mean GA at birth was 38 (28-42) weeks. The 90-day survival rate and intact discharge rate were 79 and 63%, respectively. Twelve patients had major morbidity at discharge, and 71% of these patients had physical growth or developmental retardation at 3 years of age. Conclusion: This multicenter study demonstrated that the 90-day survival rate of isolated prenatally diagnosed CDH was 79%, and that subsequent morbidity remained high. A new treatment strategy is needed to reduce the mortality and morbidity of severe CDH.

Original languageEnglish
Pages (from-to)373-378
Number of pages6
JournalPediatric Surgery International
Volume27
Issue number4
DOIs
Publication statusPublished - 2011 Apr

Keywords

  • Congenital diaphragmatic hernia
  • Fetus
  • Gentle ventilation
  • Multicenter study
  • Prenatal diagnosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Fingerprint Dive into the research topics of 'The Japanese experience with prenatally diagnosed congenital diaphragmatic hernia based on a multi-institutional review'. Together they form a unique fingerprint.

Cite this