title: Outcomes of congenital diaphragmatic hernia: a 12-year experience.
abstract: OBJECTIVE
  To determine outcomes for babies with congenital diaphragmatic hernia (CDH) diagnosed prenatally and postnatally presenting to a tertiary unit.
  
  
  METHODS
  Fetal medicine database and neonatal surgical unit admission books were reviewed to identify cases of CDH over a 12-year period (Jan 1998- Dec 2009).
  
  
  RESULTS
  A total of 132 cases of CDH were diagnosed prenatally and 39 cases diagnosed postnatally. Mean gestation at diagnosis was 22 weeks (range 13-37 weeks). Karyotyping was abnormal in 15.9%; abnormal karyotype in 3.6% of fetuses without other structural anomalies compared with 38.9% when other anomalies were identified. In 45 cases (34.1%) pregnancy was terminated. Two stillbirths occurred (2.3% of ongoing pregnancies). One hundred twenty-four babies were live born, of whom 98 babies underwent surgery. Survival to discharge of all live born babies was 72.6%; survival following surgery was 91.8%. Birthweight had a significant effect on survival (odds ratio 0.22, 95% confidence intervals 0.08-0.66). Survival for live born babies prenatally diagnosed was significantly lower (65.9%) than those diagnosed postnatally (92.3%).
  
  
  CONCLUSIONS
  Abnormal karyotype was more common when CDH was associated with other anomalies. In multivariate analysis, lower birthweight and prenatal diagnosis had a significant impact on survival. Only prenatally diagnosed CDH survival figures should be utilised in prenatal counselling.
authors.affiliation: Fetal Medicine Unit, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK. Rebekah.samangaya@cmft.nhs.uk
authors.forename: Rebekah A
authors.initials: RA
authors.lastname: Samangaya
authors.forename: Safiyya
authors.initials: S
authors.lastname: Choudhri
authors.forename: Fiona
authors.initials: F
authors.lastname: Murphy
authors.forename: Taqui
authors.initials: T
authors.lastname: Zaidi
authors.forename: Joanna C
authors.initials: JC
authors.lastname: Gillham
authors.forename: Antonino
authors.initials: A
authors.lastname: Morabito
mesh_terms: D001724:Birth Weight; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000235:genetics / Q000401:mortality; D005865:Gestational Age; D006548:Hernia, Diaphragmatic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D007621:Karyotyping; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D015996:Survival Rate; D016216:Ultrasonography, Prenatal