Incidence and Outcome of Congenital Diaphragmatic Hernia in Udonthani Hospital
Keywords:
Congenital diaphragmatic herniaAbstract
Congenital diaphragmatic hernia (CDH) is a congenital defect in the diaphragm causing pulmonary hypoplasia and pulmonary hypertension. CDH is a rare condition with high mortality rate. Majority of CDH usually died shortly after birth from pulmonary hypertension of the newborn (PPHN). The objective of retrospective study was to study the incidence and outcome of treatment for CDH in Udonthani hospital between January 2015 – December 2019. Collected data from medical records of neonates with CDH who were admitted in sick newborn unit within 28 days after birth at Udonthani hospital between January 2015 – December 2019. Analyzed by frequency, percentage, mean, S.D., median and range. Analytical statistic using Fisher exact test and Student T test.
Results: During the study period, there were 16 infants who were diagnosed CDH. 3 infants were excluded. The incidence was 5.7 cases per 10,000 live births. The male to female ratio was 3.3:1. There were 10 (76.9%) term infants, 2 (15.4%) low birth weight infants. Most of cases were referred from other hospital. Only one infant was diagnosed prenatally according to abnormal fetal ultrasonography. Common presentation symptoms were tachypnea, desaturation, increased work of breathing and usually developed within 6 hours. Chest radiograph of all cases showed bowel gas in left hemithorax. There were 2 cases with congenital anomalies (severe hydrocephalus, ambiguous genitalia). The mortality rate was 61.5% (8 of the 13 cases). The risk factor related with mortality was persistent pulmonary hypertension of the newborn (PPHN). Five survivors had performed operative management. The type of operation were primary repair in all cases. Median age at time the operation was 3 days (range 2-7). Intra-operative complication was found in 1 case which was accidental splenectomy. There was no post-operative complication. All survivors were followed up at least one year old and achieved optimal growth and development.
Conclusion: Incidence of CDH in Udonthani hospital and other studies are hardly different but higher mortality rate. The risk factor related with mortality was PPHN.
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การละเมิดลิขสิทธิ์ถือเป็นความรับผิดชอบของผู้ส่งบทความโดยตรง
ผลงานที่ได้รับการตีพิมพ์ถือเป็นลิขสิทธิ์ของผู้นิพนธ์ ขอสงวนสิทธิ์มิให้นำเนื้อหา ทัศนะ หรือข้อคิดเห็นใด ๆ ของบทความในวารสารไปเผยแพร่ทางการค้าก่อนได้รับอนุญาตจากกองบรรณาธิการ อย่างเป็นลายลักษณ์อักษร
