Population-based study of congenital diaphragmatic hernia in Utah: 1988-1994.

Update item information
Publication Type Journal Article
School or College School of Medicine
Department Pediatrics; Obstetrics & Gynecology
Creator Varner, Michael W.; Cannon, Cynthia; Ward, Robert
Other Author Dildy, Gary A.; Dudley, Donald
Title Population-based study of congenital diaphragmatic hernia in Utah: 1988-1994.
Date 1996-06
Description OBJECTIVE: To define the natural history of congenital diaphragmatic hernia and to determine the potential impact of fetal therapy. METHODS: This retrospective case series consisted of all fetuses and neonates with congenital diaphragmatic hernia born between 1988 and 1994 in the state of Utah that could be identified through genetic counseling referrals, delivery logs, and neonatal intensive care unit discharge diagnosis records. Maternal and neonatal hospital records were reviewed for antepartum, intrapartum, and postpartum variables. Based on existing recommendations, fetuses who might have benefited from fetal therapy were identified. RESULTS: Ninety-six cases were identified, for a frequency of one case in 2710 live births per year. Five pregnancies were terminated before 21 weeks' gestation. The overall survival rate excluding these five cases was 58.2%. Among the remaining 91 cases, survival was significantly better for infants diagnosed in the neonatal period than for those diagnosed prenatally (78% versus 35%; P < .001). The frequency of associated anomalies was similar for antepartum and postpartum cases. Sixty-two percent of nonsurvivors had some type of other anomaly, but no pattern was apparent. There were no accurate prenatal predictors for lethal pulmonary hypoplasia, but preterm birth and the presence of severe cardiac anomalies were predictors of neonatal death. Only two of 96 fetuses would have potentially benefited from fetal therapy. CONCLUSION: The outcome of infants with congenital diaphragmatic hernia is worse with preterm birth and if diagnosed prenatally. The survival rate we found was better than that reported in earlier studies, suggesting improved perinatal and neonatal management. Fetal therapy based on current eligibility criteria would have a minimal impact on survival of fetuses with congenital diaphragmatic hernia.
Type Text
Publisher Lippincott, Williams & Wilkins
Volume 87
Issue 6
First Page 959
Last Page 963
Subject Hernia, Diaphragmatic; Fetal Diseases; Prenatal Diagnosis; Utah/epidemiology
Subject MESH Hernia, Diaphragmatic; Abnormalities; Prenatal Diagnosis; Utah/epidemiology
Language eng
Bibliographic Citation Cannon C, Dildy GA, Ward R, Varner MW, Dudley DJ. A population-based study of congenital diaphragmatic hernia in Utah: 1988-1994. Obstet Gynecol. 1996 Jun;87(6):959-63. Retrieved on May 29th 2007 from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?orig_db=PubMed&db=PubMed&cmd=Search&term=87%5Bvolume%5D+AND+6%5Bissue%5D+AND+959%5Bpage%5D+AND+1996%5Bpdat%5D+AND+Varner+MW%5Bauthor%5D
Rights Management Copyright © Wolters Kluwer, Obstetrics and Gynecology, 87, 959-63, 1996
Format Medium application/pdf
ARK ark:/87278/s6xd1jx4
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2020-05-07
ID 703915
Reference URL https://collections.lib.utah.edu/ark:/87278/s6xd1jx4
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