Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica


IMPACT FACTOR 2018: 1.361
5-year IMPACT FACTOR: 1.578

CiteScore 2018: 1.29

SCImago Journal Rank (SJR) 2018: 0.522
Source Normalized Impact per Paper (SNIP) 2018: 0.602

Online
ISSN
1619-3997
See all formats and pricing
More options …
Volume 43, Issue 2

Issues

Associated anomalies in congenital diaphragmatic hernia: perinatal characteristics and impact on postnatal survival

Nobuhiro Hidaka
  • Corresponding author
  • Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
  • Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Keisuke Ishii
  • Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Aki Mabuchi
  • Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Akiko Yamashita
  • Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Shiyo Ota
  • Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jun Sasahara
  • Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Masaharu Murata
  • Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nobuaki Mitsuda
  • Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2014-07-11 | DOI: https://doi.org/10.1515/jpm-2014-0110

Abstract

Objective: We aimed to investigate the clinical characteristics and postnatal outcomes of fetuses with congenital diaphragmatic hernia (CDH) and additional anomalies.

Materials and methods: We reviewed the charts of fetuses with CDH managed between 2005 and 2013. Patients were divided into complex and isolated groups based on the presence of additional anomalies. We analyzed the respective polyhydramnios, liver herniation, stomach position, lung to thorax transverse area ratio (LTR), and prognoses of the two groups. The survival rates of both groups were assessed based on the LTR as well as on stomach and liver positions.

Results: CDH was diagnosed in 65 fetuses, and additional anomalies were found in 23. The incidences of liver herniation, polyhydramnios, and death were significantly higher, and LTR was significantly lower, in the complex group. The mortality rate of fetuses with a LTR <0.08 was lower than that of fetuses with a LTR of ≥0.08 in the complex group. Further, the survival rate of fetuses with intrathoracic liver was lower than those without liver herniation.

Conclusions: The prognosis of complex CDH is poor. This may result from both the associated anomalies and the severity of CDH itself. Even in complex CDHs, intrathoracic liver and LTR values are useful in estimating postnatal outcome.

Keywords: Associated anomalies; congenital diaphragmatic hernia; liver herniation; lung to thorax transverse area ratio; postnatal outcome

References

  • [1]

    Adatia, I. Congenital diaphragmatic hernia and congenital heart disease. Congenital Diaphragmatic Hernia Working Study Group; Houston, TX, 2004 Feb 19–20.Google Scholar

  • [2]

    Adzick NS, Harrison MR, Glick PL, Nakayama DK, Manning FA, De-Lorimier AA. Diaphragmatic hernia in the fetus: prenatal diagnosis and outcome in 94 cases. J Pediatr Surg. 1985;20:357–61.PubMedCrossrefGoogle Scholar

  • [3]

    Albanese CT, Lopoo J, Goldstein RB, Filly RA, Feldstein VA, Calen PW, et al. Fetal liver position and perinatal outcome for congenital diaphragmatic hernia. Prenat Diagn. 1998;18:1138–42.CrossrefPubMedGoogle Scholar

  • [4]

    Allan LD, Irish MS, Glick PL. The fetal heart in diaphragmatic hernia. Clin Perinatol. 1996;23:795–812.PubMedGoogle Scholar

  • [5]

    Bedoyan JK, Blackwell SC, Treadwell MC, Johnson A, Klein MD. Congenital diaphragmatic hernia: associated anomalies and antenatal diagnosis. Outcome-related variables at two Detroit hospitals. Pediatr Surg Int. 2004;20:170–6.PubMedGoogle Scholar

  • [6]

    Bulfamante G, Gana S, Avagliano L, Fabietti I, Gentilin B, Lalatta F. Congenital diaphragmatic hernia as prenatal presentation of Apert syndrome. Prenat Diagn. 2011; 31:910–1.Web of SciencePubMedGoogle Scholar

  • [7]

    Cohen MS, Rychik J, Bush DM, Tian ZY, Howell LJ, Adzick NS, et al. Influence of congenital heart disease on survival in children with congenital diaphragmatic hernia. J Pediatr. 2002;141:25–30.CrossrefGoogle Scholar

  • [8]

    Enns GM, Cox VA, Goldstein RB, Gibbs DL, Harrison MR, Golabi M. Congenital diaphragmatic defects and associated syndromes, malformations, and chromosome anomalies: a retrospective study of 60 patients and literature review. Am J Med Genetics. 1998;79:215–25.CrossrefGoogle Scholar

  • [9]

    Fauza DO, Wilson JM. Congenital diaphragmatic hernia and associated anomalies: their incidence, identification, and impact on prognosis. J Pediatr Surg. 1994;29:1113–7.CrossrefPubMedGoogle Scholar

  • [10]

    Flake AW. Fetal surgery for congenital diaphragmatic hernia. Semin Pediatr Surg. 1996;5:266–74.PubMedGoogle Scholar

  • [11]

    Graziano JN. Cardiac anomalies in patients with congenital diaphragmatic hernia and their prognosis: a report from the Congenital Diaphragmatic Hernia Study Group. J Pediatr Surg. 2005;40:1045–9.CrossrefGoogle Scholar

  • [12]

    Grethel EJ, Farrell J, Ball RH, Keller RL, Goldstein RB, Lee H, et al. Does congenital diaphragmatic hernia associated with bronchopulmonary sequestration portend a better prognosis? Fetal Diagn Ther. 2008;23:250–3.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [13]

    Harrison MR, Adzick NS, Estes JM, Howell LJ. A prospective study of the outcome for fetuses with diaphragmatic hernia. J Am Med Assoc. 1994;271:382–4.CrossrefGoogle Scholar

  • [14]

    Harrison MR, Bjordal RI, Landmark F, Knutrud O. Congenital diaphragmatic hernia: the hidden mortality. J Pediatr Surg. 1978;13:227–30.PubMedCrossrefGoogle Scholar

  • [15]

    Hasegawa T, Kamata S, Imura K, Ishikawa S, Okuyama H, Okada A, et al. Use of lung-thorax transverse area ratio in the antenatal evaluation of lung hypoplasia in congenital diaphragmatic hernia. J Clin Ultrasound. 1990;18:705–9.PubMedGoogle Scholar

  • [16]

    Hatch EI, Kendall J, Blumhagen J. Stomach position as an in utero predictor of neonatal outcome in left-sided diaphragmatic hernia. J Pediatr Surg. 1992;27:778–9.CrossrefGoogle Scholar

  • [17]

    Hedrick HL, Danzer E, Merchant A, Bebbington MW, Zhao H, Flake AW, et al. Liver position and lung-to-head ratio for prediction of extracorporeal membrane oxygenation and survival in isolated left congenital diaphragmatic hernia. Am J Obstet Gynecol. 2007;197:422e1–4.PubMedWeb of ScienceGoogle Scholar

  • [18]

    Jani J, Nicolaides KH, Benachi A, Moreno O, Favre R, Gratacos E, et al. Timing of lung size assessment in the prediction of survival in fetuses with diaphragmatic hernia. Ultrasound Obstet Gynecol. 2008;31:37–40.CrossrefWeb of ScienceGoogle Scholar

  • [19]

    Jani J, Nicolaides KH, Keller RL, Benachi A, Peralta CF, Favre R, et al. Antenatal-CDH-Registry Group. Observed to expected lung area to head circumference ratio in the prediction of survival in fetuses with isolated diaphragmatic hernia. Ultrasound Obstet Gynecol. 2007;30:67–71.Web of ScienceCrossrefGoogle Scholar

  • [20]

    Kitano Y, Okuyama H, Saito M, Usui N, Morikawa N, Masumoto K, et al. Re-evaluation of stomach position as a simple prognostic factor in fetal left congenital diaphragmatic hernia: a multicenter survey in Japan. Ultrasound Obstet Gynecol. 2011;37:277–82.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [21]

    Laudy JA, Van Gucht M, Van Dooren MF, Wladimiroff JW, Tibboel D. Congenital diaphragmatic hernia: an evaluation of the prognostic value of the lung-to-head ratio and other prenatal parameters. Prenat Diagn. 2003;23:634–39.CrossrefPubMedGoogle Scholar

  • [22]

    Luet’ic T, Crombleholme TM, Semple JP, D’Alton M. Early prenatal diagnosis of bronchopulmonary sequestration with associated diaphragmatic hernia. J Ultrasound Med. 1995;14:533–5.Google Scholar

  • [23]

    Manni M, Heydanus R, Den Hollander NS, Stewart RA, De Vogelaere C, Wladimiroff JW. Prenatal diagnosis of congenital diaphragmatic hernia: a retrospective analysis of 28 cases. Prenat Diagn. 1994;14:187–90.PubMedCrossrefGoogle Scholar

  • [24]

    Menon SC, Tani LY, Weng HY, Lally PA, Lally KP, Yoder BA, Congenital Diaphragmatic Hernia Study Group. Clinical characteristics and outcomes of patients with cardiac defects and congenital diaphragmatic hernia. J Pediatr. 2013;162:114–9.CrossrefGoogle Scholar

  • [25]

    Nagata K, Usui N, Kanamori Y, Takahashi S, Hayakawa M, Okuyama H, et al. The current profile and outcome of congenital diaphragmatic hernia: a nationwide survey in Japan. J Pediatr Surg. 2013;48:738–44.CrossrefGoogle Scholar

  • [26]

    Ruano R, Takashi E, da Silva MM, Campos JA, Tannuri U, Zugaib M. Prediction and probability of neonatal outcome in isolated congenital diaphragmatic hernia using multiple ultrasound parameters. Ultrasound Obstet Gynecol. 2012;39:42–9.CrossrefWeb of ScienceGoogle Scholar

  • [27]

    Ryan CA, Finer NN, Etches PC, Tierney AJ, Peliowski A. Congenital diaphragmatic hernia: associated malformations – cystic adenomatoid malformation, extralobular sequestration, and laryngotracheoesophageal cleft: two case reports. J Pediatr Surg. 1995;883–5.CrossrefGoogle Scholar

  • [28]

    Skari H, Bjornland K, Haugen G, Egeland T, Emblem R. Congenital diaphragmatic hernia: a meta-analysis of mortality factors. J Pediatr Surg. 2000;35:1187–97.PubMedCrossrefGoogle Scholar

  • [29]

    Tonks A, Wyldes M, Somerset DA, Dent K, Abhyankar A, Bagchi I, et al. Congenital malformations of the diaphragm: Findings of the West Midlands Congenital Anomaly Register 1995–2000. Prenat Diagn. 2004;24:596–604.Google Scholar

  • [30]

    Tsukimori K, Masumoto K, Morokuma S, Yoshimura T, Taguchi T, Hara T, et al. The lung-to-thorax transverse area ratio at term and near term correlates with survival in isolated congenital diaphragmatic hernia. J Ultrasound Med. 2008;27:707–13.PubMedGoogle Scholar

  • [31]

    Usui N, Kitano Y, Okuyama H, Saito M, Morikawa N, Takayasu H, et al. Reliability of the lung to thorax transverse area ratio as a predictive parameter in fetuses with congenital diaphragmatic hernia. Pediatr Surg Int. 2011;27:39–45.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [32]

    Victoria T, Bebbington MW, Danzer E, Flake AW, Johnson MP, Dinan D, et al. Use of magnetic resonance imaging in prenatal prognosis of the fetus with isolated left congenital diaphragmatic hernia. Prenat Diagn. 2012;32:715–23.CrossrefWeb of ScienceGoogle Scholar

  • [33]

    Witters I, Devriendt K, Moerman P, van Hole C, Fryns JP. Diaphragmatic hernia as the first echographic sign in Apert syndrome. Prenat Diagn. 2000;20:404–6.PubMedCrossrefGoogle Scholar

  • [34]

    Witters I, Legius E, Moerman P, Deprest J, Van Schoubroeck D, Timmerman D, et al. Associated malformations and chromosomal anomalies in 42 cases of prenatally diagnosed diaphragmatic hernia. Am J Med Genetics. 2001;103:278–82.CrossrefGoogle Scholar

  • [35]

    Zaiss I, Kehl S, Link K, Neff W, Schaible T, Sutterlin M, et al. Associated malformations in congenital diaphragmatic hernia. Am J Perinatol. 2011;28:211–8.CrossrefPubMedGoogle Scholar

About the article

Corresponding author: Nobuhiro Hidaka, Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan, Tel.: +81-92-642-5395, Fax: +81-92-642-5414, E-mail: ; and Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan


Received: 2014-03-31

Accepted: 2014-06-11

Published Online: 2014-07-11

Published in Print: 2015-03-01


Citation Information: Journal of Perinatal Medicine, Volume 43, Issue 2, Pages 245–252, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2014-0110.

Export Citation

©2015 by De Gruyter.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Louise Montalva, Giuseppe Lauriti, and Augusto Zani
Journal of Pediatric Surgery, 2019, Volume 54, Number 5, Page 909
[2]
Kitty G. Snoek, Anne Greenough, Joost van Rosmalen, Irma Capolupo, Thomas Schaible, Kamal Ali, René M. Wijnen, and Dick Tibboel
Neonatology, 2018, Page 63
[3]
Tara A. Morgan, Dorothy J. Shum, Amaya M. Basta, and Roy A. Filly
Journal of Fetal Medicine, 2017, Volume 4, Number 2, Page 57
[4]
Takeshi MURAKAMI, Nobuhiro HIDAKA, Saki KIDO, Kotaro FUKUSHIMA, Koji NAGATA, Tomoaki TAGUCHI, and Kiyoko KATO
Choonpa Igaku, 2015, Volume 42, Number 3, Page 353

Comments (0)

Please log in or register to comment.
Log in