The prognosis of ex-utero intrapartum treatment for CDH: a retrospective study

Abstract

Background To explore the impact of ex-utero intrapartum treatment (EXIT) on the prognosis of fetuses antenatally diagnosed with congenital diaphragmatic hernia (CDH). Methods We retrospectively reviewed the clinical data of 76 patients with CDH. All patients were divided into two groups: the EXIT group and the non-EXIT group. The propensity score matching (PSM) was performed. The primary outcome was survival at 28-day after birth. The neonatal outcomes were evaluated. Results There were 7 fetuses who received EXIT and 7 fetuses who did not receive EXIT were matched by PSM. There were no differences in the first diagnosed gestational age of CDH, location of hernia, presence of liver hernia, the lowest o/e LHR during pregnancy, premature birth, and fetal birth weight between the two groups. All the patients in the two groups were survival beyond 28-day after birth. The duration of mechanical ventilation was shorter in the EXIT group (1 day) compared to the non-EXIT group (3 days) (P = 0.03). The surgical operation costs were lower in the EXIT group (1748.00 RMB) compared to the non-EXIT group (3325.00 RMB, P = 0.002). Conclusions Performing the EXIT for repairing defects and establishing an airway is a safe and effective method for treating CDH, which can reduce postoperative ventilator usage time and surgical-related costs.