Congenital diaphragmatic hernia in the neonates-review od 10-year experience



Rok publikování 2016
Druh Další prezentace na konferencích
Fakulta / Pracoviště MU

Lékařská fakulta

Popis AIM: The prognosis of the children with CDH remains unsatisfactory despite recent advances in medical and surgical treatment including gore-tex patches. In our poster we would like to point to the importance of interdisciplinary collaboration including gynecologist, obstertician, neonatologist and surgeon. METHODS: We retrospectively reviewed medical records of neonates with CDH admitted to the University Hospital Brno. Prenatal and postnatal factors, birth details, managment were studied. RESULTS: We admitted 29 neonates with CDH who fullified the study criterias. 28 patients /97%/ had left-sided Bochdalek hernia, only 1 patient had right-sided Morgagni hernia. The mean gestational age was 37,5 weeks /range 31.-41.wA 9 neonates /33%/were prenatally diagnosed by using ultrasound or MRI and therefore they were delivered in the tertiary perinatal centre. The operation was performed in almost all of the patiens the first day. Average duration of the mechanical ventilation was 8,5 days, a severe pulmonary hypertension developed in 5 patients with the need of high frequency oscilatory ventilation. Two neonates died in early postoperative period. The reoperation was needed in 3 patients during the neonatal period. CONCLUSION: The surgery after birth is not an emergency and is usually performed when the baby has stabilized. In our review the size of the defect wasn't the determing factor for the mortality rate which was 7% in our case. We have learned that the severity and outcome is determined by 3 factors - other associated malformations, pulmonary hypertension and low gestational age .

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