The hidden mortality of congenital diaphragmatic hernia: a 20-year review

摘要: Aims: The true mortality associated with congenital diaphragmatic hernia (CDH) is hidden because survival analyses do not include fetuses CDH. A retrospective review of all postmortems (PMs) a diagnosis CDH over 20-year period was carried out to highlight this and also measure the nature number anomalies. Methods: Postmortem case record details were reviewed for January 1986 December 2005. Data collected on live birth, stillbirth, therapeutic abortion, spontaneous abortion. Results: There decline in annual PMs during study. median four 5-year intervals being 609 (570-657), 528 (488-565), 515 (413-537), 373 (357-388). total 130 identified, which included CDH; 97 (75%) left sided, 22 (17%) right 11 (8%) bilateral. 69 births, 46 abortions, 10 stillbirths, 5 intrauterine deaths; 22% sided/bilateral abortion groups, whereas 53% latter 2 groups. Of 130, 82 (63%) had major anomalies, 50% these at least 1 further anomaly. commonest categories anomalies cardiac (30), gastrointestinal/abdominal wall defect (28), neural tube defects (25). Conclusions: incidence considerably higher than that seen neonatal surgical practice. our region will exacerbate underestimation incidence. right-sided/bilateral hernias more one anomaly those who die utero.