PROGNOSTIC FACTORS IN CONGENITAL DIAPHRAGMATIC HERNIA IN NEONATES. CLINICAL CASE SERIES AND LITERATURE REVIEW

Abstract

Congenital diaphragmatic hernia (CDH) is one of the most serious congenital disorders and it is associated with a high mortality and morbidity. It occurs in 1 of 3,000 live born newborns. Despite improvements in perinatal diagnosis and treatment,mortality rates from congenital diaphragmatic hernia remain high at 30–70% for 1 year outcomes. Focusing on this topic, analyzing prognostic factors and improving treatment strategies are the most important steps in higher survival rates for newborns with CDH. Based on the newest literature, the main prognostic factors related to the CDH itself are its size and localization, the status of the newborn (birth weight, prematurity, 5min. APGAR score), pulmonary hypertension and its severity. Prognostic factors, associated with diagnosis and treatment, are: the time of making such a diagnosis, the time of diaphragm plastic surgery, postoperative course and application of ECMO. In this article four clinical cases with CDH of Vilnius University Hospital Santaros Klinikos are analyzed and a literature overview about the main prognostic factors for neonates born with congenital diaphragmatic hernia is given.