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.