Congenital diaphragmatic hernia: Impact of contemporary management strategies on perinatal outcomes

Han-Shin Lee, Jan E Dickinson, Jason Tan, Wendy Nembhard, Carol Bower

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To review temporal changes in perinatal management and one-year survival outcomes of cases of congenital diaphragmatic hernia (CDH) from 1996-2015 in Western Australia (WA).

METHOD: Retrospective study of all cases of CDH in WA from 1996 to 2015, identified from 5 independent databases within the WA health network. Detailed information pertaining to pregnancy and survival outcomes were obtained from review of maternal and infant medical records.

RESULTS: There were 215 cases of CDH with 164 diagnosed prenatally. Between 1996-2010, a decline in livebirth rates for CDH-affected pregnancies was observed, reaching a nadir of 5.3 per 10,000 births, before increasing to a peak of 9.73 per 10,000 births in 2011-2015. A corresponding decline was seen in the number of pregnancies terminated in the same period, from 8.3 to 4.6 per 10,000 births (P = .14) and an increase in survival of livebirths, from 38.9% to 81.3% (P = 0.01).

CONCLUSION: The improved overall survival rate in infants with CDH over the last 20 years may have resulted in an increased tendency for women to continue their pregnancy with a concomitant decline in termination rates. Information from this study will help in the counselling of women following prenatal detection of CDH.

Original languageEnglish
Pages (from-to)1004-1012
JournalPrenatal Diagnosis
Volume38
Issue number13
DOIs
Publication statusPublished - Dec 2018

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Western Australia
Parturition
Pregnancy
Survival
Pregnancy Outcome
Medical Records
Congenital Diaphragmatic Hernias
Counseling
Survival Rate
Retrospective Studies
Mothers
Databases
Health

Cite this

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abstract = "OBJECTIVE: To review temporal changes in perinatal management and one-year survival outcomes of cases of congenital diaphragmatic hernia (CDH) from 1996-2015 in Western Australia (WA).METHOD: Retrospective study of all cases of CDH in WA from 1996 to 2015, identified from 5 independent databases within the WA health network. Detailed information pertaining to pregnancy and survival outcomes were obtained from review of maternal and infant medical records.RESULTS: There were 215 cases of CDH with 164 diagnosed prenatally. Between 1996-2010, a decline in livebirth rates for CDH-affected pregnancies was observed, reaching a nadir of 5.3 per 10,000 births, before increasing to a peak of 9.73 per 10,000 births in 2011-2015. A corresponding decline was seen in the number of pregnancies terminated in the same period, from 8.3 to 4.6 per 10,000 births (P = .14) and an increase in survival of livebirths, from 38.9{\%} to 81.3{\%} (P = 0.01).CONCLUSION: The improved overall survival rate in infants with CDH over the last 20 years may have resulted in an increased tendency for women to continue their pregnancy with a concomitant decline in termination rates. Information from this study will help in the counselling of women following prenatal detection of CDH.",
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Congenital diaphragmatic hernia : Impact of contemporary management strategies on perinatal outcomes. / Lee, Han-Shin; Dickinson, Jan E; Tan, Jason; Nembhard, Wendy; Bower, Carol.

In: Prenatal Diagnosis, Vol. 38, No. 13, 12.2018, p. 1004-1012.

Research output: Contribution to journalArticle

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