Congenital Diaphragmatic Hernia: high mortality in spite of different treatment options.

Abstract

Abstract Introduction: Congenital diaphragmatic hernia (CDH) is a fatal condition that affects intrauterine lung development, resulting in pulmonary hypoplasia and persistent pulmonary hypertension. Methods: Given the scarcity of medical information indexed in low- and middle-income countries, the objective of this study was to characterize newborns with CDH treated at the San Ignacio University Hospital (HUSI) in Bogotá, Colombia over a time period of 11 years. Results and discussion: Within this population, 27 patients with CDH were treated: 81% were diagnosed prenatally by ultrasound, but only 14% had records of prenatal prognostic indices. The location of the defect was predominantly on the left side and the majority were male neonates (85% and 74% respectively). The mean gestational age was 37.2 weeks and the average weight was 2805 grams. 12 patients died prior to surgical correction. In 11 patients there were associated congenital malformations and 53.4% had postoperative complications. There was a postoperative mortality of 6 patients. Conclusions: Taking into account that CDH is an infrequent pathology with high mortality, the possibility of improving patient assessment was found by optimizing the protocol for prenatal assessment and postnatal treatment. The importance of monitoring epidemiological data in low- and middle-income countries is highlighted.