Clinical profile of congenital diaphragmatic hernia and their short-term outcome in a tertiary care neonatal unit: A retrospective study
Journal Title: Indian Journal of Child Health - Year 2017, Vol 4, Issue 3
Abstract
Background: Recent developments in the antenatal diagnosis, surgical techniques, and neonatal intensive care had widely increased survival rates in neonates with congenital diaphragmatic hernia (CDH) in the western world. In developing countries, however, high mortality in neonates with CDH still continues to be a challenge. Objective: The aim of this study is to study the clinical profile of neonates with CDH and to analyze the various factors affecting mortality. Materials and Methods: In this retrospective study, 148 babies with a diagnosis of diaphragmatic hernia admitted to a tertiary care neonatal unit in South India, from the year 2010 to 2015, were reviewed. Results: The total survival rate was 58.1%, and the operative survival rate was 85.1%. Prenatal diagnosis was made in only 7 cases, and of these, 5 (71.42%) survived. Higher mortality was associated with age at admission <24 h, low Apgar score, early onset of respiratory distress, right-sided CDH, presence of persistent pulmonary hypertension of newborn, and high FiO2 requirement at the time of admission, during stabilization and surgery (p<0.01). Significantly higher mortality was also observed among babies who required positive-pressure ventilation during transport, required inotropes during hospital course (p<0.01), and had low PaO2, high PCO2, and high oxygenation index (p<0.01). Conclusion: Babies admitted to hospital within 24 h of age and who manifested early had a poor outcome indicating severe disease. Antenatal diagnosis of this condition should improve to prevent delay in stabilization and poor outcome.
Authors and Affiliations
M Molugan, C N Kamalarathnam, J Muthukumaran
Keywords
Related Articles
- EP ID EP456526
- DOI -
- Views 74
- Downloads 0
Herpes simplex virus encephalitis in an 8 years old with normal cerebrospinal fluid and negative herpes simplex virus polymerase chain reaction - A clinical and radiological diagnosis
Herpes simplex encephalitis is known to cause significant morbidity and mortality both in children and adults. Polymerase chain reaction (PCR) for herpes simplex virus (HSV) in cerebrospinal fluid (CSF) is the diagnostic...
Effect of intravenous fluid supplementation in healthy term neonates with nonhemolytic hyperbilirubinemia: A randomized controlled trial
Objective: The objective of this study was to evaluate the effect of intravenous fluid supplementation in healthy term neonates with non-hemolytic hyperbilirubinemia receiving phototherapy. Study Design: Randomized contr...
Assessment of fetal nutrition status at birth using the clinical assessment of nutritional status score
Introduction: Assessment of fetal malnutrition (FM) among neonates has been a major concern to health personnel due to the potentially serious sequelae of malnutrition on multiple organ systems. There is a dearth of rese...
Correlation between umbilical venous blood gas at birth and comorbidities in preterm babies - A cohort study
Background: Umbilical cord blood gas analysis is a useful tool in predicting short-term outcomes in term infants. The value of umbilical venous blood gas analysis in predicting short-term outcomes in preterm infants is l...
Clinicoetiology profile of neonatal seizures in tertiary care Level II neonatal intensive care unit
Objective: To study the incidence, etiology, and pattern of neonatal seizures and its relationship with age of onset, gestation, and other obstetrical factors. Design: Prospective observational descriptive study. Setting...