Antenatal detection and impact on outcome of congenital diaphragmatic hernia: A 12-year experience in Auvergne (France)

Gallot, Denis; Coste, Karen; Francannet, Christine; Laurichesse, Hélène; Boda, C.; Ughetto, Sylvie; Vanlieferinghen, P; Scheye, T; Vendittelli, Françoise; Labbé, A.; Déchelotte, P.; Sapin, Vincent; Lémery, D.

doi:10.1016/j.ejogrb.2005.06.030

Cited by 79 publications

(57 citation statements)

References 18 publications

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“…Population-based statistics remain our best source of information (Ontario Congenital Anomalies Study Group, 2004). Studies from France, Australia and the United Kingdom report survival rates of between 50 and 70% for isolated CDH (Stege et al, 2003;Colvin et al, 2005;Gallot et al, 2005). That this is a realistic estimate is confirmed by a comparable 60-70% survival rate reported by the CDH study group (Moya and Lally, 2005).…”

Section: Neonatal Management and The Difficulty Of Assessing Exact Susupporting

confidence: 64%

Prenatal diagnosis, prediction of outcome and in utero therapy of isolated congenital diaphragmatic hernia

et al. 2008

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Congenital diaphragmatic hernia (CDH) can be associated with genetic or structural anomalies with poor prognosis. In isolated cases, survival is dependent on the degree of lung hypoplasia and liver position. Cases should be referred in utero to tertiary care centers familiar with this condition both for prediction of outcome as well as timed delivery. The best validated prognostic indicator is the lung area to head circumference ratio. Ultrasound is used to measure the lung area of the index case, which is then expressed as a proportion of what is expected normally (observed/expected LHR). When O/E LHR is <25% survival chances are <15%. Prenatal intervention, aiming to stimulate lung growth, can be achieved by temporary fetal endoscopic tracheal occlusion (FETO). A balloon is percutaneously inserted into the trachea at 26-28 weeks, and reversal of occlusion is planned at 34 weeks. Growing experience has demonstrated the feasibility and safety of the technique with a survival rate of about 50%. The lung response to, and outcome after FETO, is dependent on pre-existing lung size as well gestational age at birth. Early data show that FETO does not increase morbidity in survivors, when compared to historical controls. Several trials are currently under design.

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Section: Neonatal Management and The Difficulty Of Assessing Exact Susupporting

confidence: 64%

Prenatal diagnosis, prediction of outcome and in utero therapy of isolated congenital diaphragmatic hernia

et al. 2008

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“…Colvin et al (18) and Gallot et al, (20) where close to half of the cases opted for TOP. However, this is in contrast to other studies where TOP rates ranged from 21% to 44%.…”

Section: Discussionmentioning

confidence: 99%

“…(10) Notably, our data suggest that The mean gestational age at diagnosis in our study corresponds to that in other studies, which ranges from 19 to 29 weeks. (6,(18)(19)(20)(21) The majority of cases are similarly diagnosed via fetal anomaly imaging, which is conducted from 18 to 20 weeks of gestation. (22) Although left-sided CDH has been found to be most common, (11,19,(22)(23)(24) our study is unique in that right-sided, bilateral and central forms of CDH were not detected.…”

Section: Discussionmentioning

confidence: 99%

Antenatally diagnosed congenital diaphragmatic hernia in Singapore: a five-year series

Lee¹,

Tan²

2013

smedj

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O r i g i n a l A r tic le 432 I NTRO D U C TIO NCongenital diaphragmatic hernia (CDH), a rare malformation with an incidence of 1.7-5.7 per 10,000 live births, remains one of the most fatal causes of severe respiratory failure.(1,2) CDH was first described by Riveriusin 1672, (3) with the types of defects classified by Morgagni in 1769.(4) The posterolateral defect that we now know as the most common type of CDH was described by Bochdalek in 1848. M E TH O DSAll CDH cases diagnosed antenatally in KKH between January 2006 and December 2010 were obtained using the discharge summary codes and retrospectively reviewed.Population denominators were obtained from KKH's perinatal statistics database. The incidences were calculated according to the format used by the National Birth Defects Registry.Detailed information was collected from the maternal medical records, which included demographic characteristics such as gestational age at diagnosis, method of diagnosis, ultrasonographic findings, prognostication factors (e.g. LHR,FLV and MPA diameter), presence of other anomalies, followup care (e.g. karyotyping, frequency of follow-up appointments and referral to paediatric surgical service), outcome of

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“…Ultrasound is the standard prenatal imaging modality for detection of congenital anomalies including CDH. However, the diagnosis is particularly difficult before 24 weeks of gestation (22-52 % of the cases), and even after 24 weeks of gestation, the prenatal diagnosis is a challenge, with more than 25 % of cases missed and 11 % diagnosed postnatally [8]. The diagnosis of CDH is usually suspected by the absence of stomach in the normal intra-abdominal location; intrathoracic mass containing the liver, bowel, or stomach; or by indirect evidence such as abnormal cardiac axis, mediastinal shift, or polyhydramnios.…”

Section: Prenatal Imagingmentioning

confidence: 99%

Current Concepts in the Management of Congenital Diaphragmatic Hernia in Infants

Kumar

2015

Indian J Surg

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The therapeutic approach to congenital diaphragmatic hernia (CDH) has shifted from one of immediate repair to management of pulmonary hypertension, physiologic stabilization, and delayed surgical repair. Lung hypoplasia, remodeled pulmonary vasculature, and ventricular dysfunction all contribute to the high morbidity and mortality associated with CDH. In addition, genetic syndromes associated with CDH can increase the incidence of serious anomalies and hence impact survival. Prenatal and postnatal management of infants with CDH is challenging in the best of circumstances and need multidisciplinary teams for optimal outcomes. However, advances using ultrasound and fetal MRI can predict prognosis and survival and plan for postnatal management. Survival rates for patients with CDH have increased for the past decade with better management at resuscitation; implementation of gentle ventilation strategies; and medical management of pulmonary hypertension, physiologic stabilization, and extracorporeal membrane oxygenation. However, follow-up of these infants for long-term morbidities is essential for optimal outcomes after discharge. . Lung hypoplasia and pulmonary hypertension are key factors which contribute to the morbidity and mortality associated with CDH.

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Antenatal detection and impact on outcome of congenital diaphragmatic hernia: A 12-year experience in Auvergne (France)

Cited by 79 publications

References 18 publications

Prenatal diagnosis, prediction of outcome and in utero therapy of isolated congenital diaphragmatic hernia

Prenatal diagnosis, prediction of outcome and in utero therapy of isolated congenital diaphragmatic hernia

Antenatally diagnosed congenital diaphragmatic hernia in Singapore: a five-year series

Current Concepts in the Management of Congenital Diaphragmatic Hernia in Infants

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