PURPOSE: The purpose of this study was to evaluate the relationship between the presence of a hernia sac and fetal lung growth and outcomes in infants with Congenital, Diaphragmatic Hernia (CDH). METHODS: The medical records of all neonates with CDH treated in our institution between 2004 and 2011 were reviewed. The presence of a hernia sac was confirmed at the time of surgical repair or at autopsy. Data were analyzed using parametric and non-parametric tests where appropriate. Multivariable regression and survival analyses were applied. RESULTS: Of 148 neonates treated for CDH, 107 (72%) had isolated CDH and 30 (20%) had a hernia sac. Infants with a hernia sac had significantly lower need for ECMO, patch repair, supplemental oxygen at 30 days of life, and shorter duration of mechanical ventilation and hospital stay. Ninety-three patients had prenatal imaging. The mean observed-to-expected total fetal lung volume in the sac group was higher throughout gestation. Although a greater percentage of sac patients had liver herniation as a dichotomous variable, the amount of herniated liver (%LH and LiTR) was significantly lower in the presence of a hernia sac. CONCLUSION: The presence of a hernia sac in Congenital Diaphragmatic Hernia is associated with less visceral herniation, greater fetal lung growth, and better post-natal outcomes.
PURPOSE: The purpose of this study was to evaluate the relationship between the presence of a hernia sac and fetal lung growth and outcomes in infants with Congenital, Diaphragmatic Hernia (CDH). METHODS: The medical records of all neonates with CDH treated in our institution between 2004 and 2011 were reviewed. The presence of a hernia sac was confirmed at the time of surgical repair or at autopsy. Data were analyzed using parametric and non-parametric tests where appropriate. Multivariable regression and survival analyses were applied. RESULTS: Of 148 neonates treated for CDH, 107 (72%) had isolated CDH and 30 (20%) had a hernia sac. Infants with a hernia sac had significantly lower need for ECMO, patch repair, supplemental oxygen at 30 days of life, and shorter duration of mechanical ventilation and hospital stay. Ninety-three patients had prenatal imaging. The mean observed-to-expected total fetal lung volume in the sac group was higher throughout gestation. Although a greater percentage of sac patients had liver herniation as a dichotomous variable, the amount of herniated liver (%LH and LiTR) was significantly lower in the presence of a hernia sac. CONCLUSION: The presence of a hernia sac in Congenital Diaphragmatic Hernia is associated with less visceral herniation, greater fetal lung growth, and better post-natal outcomes.
Authors: Edward R Oliver; Suzanne E DeBari; Samantha E Adams; Ryne A Didier; Steven C Horii; Teresa Victoria; Holly L Hedrick; N Scott Adzick; Lori J Howell; Julie S Moldenhauer; Beverly G Coleman Journal: Pediatr Radiol Date: 2019-01-11
Authors: Valerie K Jordan; Tyler F Beck; Andres Hernandez-Garcia; Peter N Kundert; Bum-Jun Kim; Shalini N Jhangiani; Tomasz Gambin; Molly Starkovich; Jaya Punetha; Ingrid S Paine; Jennifer E Posey; Alexander H Li; Donna Muzny; Chih-Wei Hsu; Amber J Lashua; Xin Sun; Caraciolo J Fernandes; Mary E Dickinson; Kevin P Lally; Richard A Gibbs; Eric Boerwinkle; James R Lupski; Daryl A Scott Journal: Hum Mol Genet Date: 2018-06-15 Impact factor: 6.150
Authors: Kim Heiwegen; Arno Fj van Heijst; Horst Daniels-Scharbatke; Michelle Cp van Peperstraten; Ivo de Blaauw; Sanne Mbi Botden Journal: Eur J Pediatr Date: 2020-01-22 Impact factor: 3.183