Perinatal outcome of congenital diaphragmatic hernia in an Australian tertiary hospital.

BACKGROUND: Congenital diaphragmatic hernia (CDH) is a potentially correctable anatomical defect that continues to represent a significant cause of stillbirth and neonatal death.

AIMS: To describe the outcomes of fetuses diagnosed antenatally with CDH.

METHODS: A retrospective cohort study of fetuses with CDH detected antenatally at our fetal medicine unit between January 1996 and December 2008. The study analyses factors associated with mortality in a setting where no fetal intervention for this condition is performed.

RESULTS: Eighty-six cases were identified and 75.5% of infants were born alive. Mortality prior to corrective surgery was 7%. The survival rate for babies born at term with isolated CDH was 83%. Presence of an additional anomaly, herniated liver and preterm delivery were associated with increased mortality. Seventy-four percent of liveborn infants with either isolated CDH or other anomalies survived to discharge.

CONCLUSIONS: Although the overall mortality rate for this condition remains high, fetuses with isolated CDH born at term have relatively high survival rates. This study provides data for counselling parents in tertiary centres with advanced neonatal care but where antenatal intervention for this condition has not been introduced.