964 Outcome of Liveborn Infants with Congenital Diaphragmatic Hernia in a Tertiary Neonatal Unit

Abstract

Background and aims: The incidence of congenital diaphragmatic hernia (CDH) is approximately 1 in 3000 with reported survival of 60-70%[1]. The aim of this study was to review management and outcome of all live born babies with CDH delivered at Birmingham Women's Hospital from January 2000-December 2009.

Methods: Retrospective case-note review of babies with CDH identified by their clinical diagnosis code. Trust audit department approval was obtained.

Results: 60 live newborns with CDH were identified. Median gestational age at birth was 39 weeks (range 33-42 weeks). The median birth weight was 2970g (range 1080-4090g). There were 35 boys (58%). 53 cases were left sided. 3 babies died in delivery suite despite active resuscitation. 18 babies died on the neonatal unit despite full intensive care. 6 were referred for ECMO(5 of these survived). 33 babies were transferred to PICU but 3 babies died before surgery (1 unknown). 29 babies had surgery and 2 died post-surgery. The 30 day surgical survival rate was 93%. 32 babies are alive to date (1 unknown).

Conclusion: In our experience, 35% of babies died in the immediate neonatal period. Transfer for ECMO has been a recent practice with 83% survival. 30 day surgical survival was 93%. However, the overall survival of a live born baby with CDH was 53%. Therefore, when counselling parents in the antenatal period, it is important to quote all figures rather than surgical survival alone.

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