[Diaphragmatic hernia in reference hospital ICZMP--diagnostic problems and outcome].
OBJECTIVE
The aim of the study was to analyze US/ECHO examinations in fetuses with diaphragmatic hernia (DH) diagnosed and treated in our institution from 1994-2006, and their follow-up.


METHODS
Retrospective analysis of the data base from Department for Diagnoses & Prevention of Fetal Malformations, Research Institute of the Polish Mother's Memorial Hospital: 14,481 fetal echo/ultrasound examinations in 10,077 fetuses have been analyzed to retrieve 115 fetuses with DH.


RESULTS
The mean gestational age at the targeted US/ECHO examination was 30 wks. There were 8 terminations of pregnancies (at mean 21 wks), 6 intrauterine demises, 60 neonatal deaths after delivery (in 1-3rd day of postnatal life), 8 deaths after surgery, 19 neonates were discharged home and in 14 cases the follow-up could not be monitored. The most common anomalies accompanying DH have been central nervous system anomalies (20%), polyhydramnion (16%) and cong heart defects (10%). In this subgroup, there was 100% mortality. Isolated DH has been diagnosed in every third case. In this subgroup, 27 neonates had undergone surgery and the survival rate was 70%, however since 2004 there was not a single death on record.


CONCLUSIONS
Late gestational age of US/ECHO examinations in our tertiary center suggests that DH has been relatively difficult to detect during ultrasound screening. DH and the other structural malformations have been a lethal disease in our series in 100%. Isolated DH was much less frequent and was present in every third case (29%), and in this group the survival rate was 70%, regardless of the way of the delivery (CS or Vaginal).
Zakład Diagnostyki i Profilaktyki Wad Wrodzonych ICZMP & Uniwersytetu Medycznego w Łodzi. majkares@uni.lodz.pl
Maria
M
Respondek-Liberska
Sebastian
S
Foryś
Joanna
J
Janiszewska-Skorupa
Krzysztof
K
Szaflik
Jan
J
Wilczyński
Przemysław
P
Oszukowski
Grzegorz
G
Krasomski
Iwona
I
Maroszyńska
Tadeusz
T
Biegański
Andrzej
A
Kulig
Lucjusz
L
Jakubowski
Andrzej
A
Chilarski
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000032:Abortion, Therapeutic / Q000706:statistics & numerical data; D000047:Academies and Institutes; D003937:Diagnosis, Differential; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging* / Q000453:epidemiology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011044:Poland; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000379:methods*