Congenital diaphragmatic hernia associated with spinal anomalies.
OBJECTIVE
Increased mortality is seen in patients with congenital diaphragmatic hernia who have associated anomalies, such as cardiac defects. We reviewed our series of patients with congenital diaphragmatic hernia and spinal anomalies to evaluate if their prognosis was altered.


METHODS
We examined our institutional database from August 1995 to August 2005, examining 679 cases of congenital diaphragmatic hernia, identifying all fetuses and newborns with congenital diaphragmatic hernia and spinal anomalies. Patients who had both congenital diaphragmatic hernia and spinal anomalies were identified by prenatal ultrasound reports, postnatal radiographs, operative notes, and pathology reports.


RESULTS
Seven patients were identified in the fetal or neonatal period with concomitant diagnoses of congenital diaphragmatic hernia and spinal anomalies. All patients had normal karyotype analysis. Six of these patients had both defects diagnosed using prenatal ultrasonography. All patients died before hospital discharge.


CONCLUSIONS
Although the numbers are limited in our series, patients with congenital diaphragmatic hernia and spinal anomalies have a dismal prognosis. This finding has significant implications for prenatal counseling.


METHODS
III.
Grethel
Erich J
EJ
Fetal Treatment Center, Division of Pediatric Surgery, University of California, San Francisco, San Francisco, California 94143-0570, USA. egrethel@yahoo.com
Farrell
Jody
J
Ball
Robert
R
Lee
Hanmin
H
Nobuhara
Kerilyn K
KK
D000015:Abnormalities, Multiple / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D002140:California / Q000453:epidemiology; D005260:Female; D006548:Hernia, Diaphragmatic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008499:Medical Records; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D013116:Spinal Cord / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014463:Ultrasonography