Congenital diaphragmatic hernia: improved surgical results should influence abortion decision making

2.50
Hdl Handle:
http://hdl.handle.net/2336/29545
Title:
Congenital diaphragmatic hernia: improved surgical results should influence abortion decision making
Authors:
Gudbjartsson, T; Gunnarsdottir, A; Topan, C Z; Larssons, L T; Rosmundsson, Th; Dagbjartsson, A
Citation:
Scand J Surg. 2008, 97(1):71-6
Issue Date:
15-Mar-2008
Abstract:
AIMS: To compare surgical results for congenital diaphragmatic hernia (CDH) in two Scandinavian university hospitals and to evaluate the effects of abortions on the clinical profile of CDH in Iceland. METHODS: A retrospective study including all CDH-cases in Iceland 1983-2002 and children referred to Lund University Hospital 1993-2002. Aborted fetuses with CDH from a nation-wide Icelandic abort-registry were also included. RESULTS: In Iceland, 19 out of 23 children with CDH were diagnosed < 24 hours from delivery, one with associated anomalies. Eight fetuses were diagnosed prenatally and seven of them aborted, three having isolated CDH at autopsy. In Iceland, 15 of 18 children operated on survived surgery (83% operative survival). In Lund 28 children were treated with surgery, 23 of them diagnosed early after birth or prenatally. Four children did not survive surgery (86% operative survival) and 9 (31%) had associated anomalies. All the discharged children treated in Iceland and Lund are alive, 3-22 years postoperatively. CONCLUSION: CDH is a serious anomaly where morbidity and mortality is directly related to other associated anomalies and pulmonary hypoplasia. However, majority of CDH patients do not have other associated anomalies. In spite of improved surgical results (operative mortality < 20%), a large proportion of pregnancies complicated with CDH are terminated. We conclude that the improved survival rate after corrective surgery must be emphasized when giving information to parents regarding abortion of fetuses with a prenatally diagnosed CDH.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://www.fimnet.fi/sjs/articles/SJS12008-71.pdf

Full metadata record

DC FieldValue Language
dc.contributor.authorGudbjartsson, T-
dc.contributor.authorGunnarsdottir, A-
dc.contributor.authorTopan, C Z-
dc.contributor.authorLarssons, L T-
dc.contributor.authorRosmundsson, Th-
dc.contributor.authorDagbjartsson, A-
dc.date.accessioned2008-06-04T15:37:33Z-
dc.date.available2008-06-04T15:37:33Z-
dc.date.issued2008-03-15-
dc.date.submitted2008-06-04-
dc.identifier.citationScand J Surg. 2008, 97(1):71-6en
dc.identifier.issn1457-4969-
dc.identifier.pmid18450209-
dc.identifier.urihttp://hdl.handle.net/2336/29545-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractAIMS: To compare surgical results for congenital diaphragmatic hernia (CDH) in two Scandinavian university hospitals and to evaluate the effects of abortions on the clinical profile of CDH in Iceland. METHODS: A retrospective study including all CDH-cases in Iceland 1983-2002 and children referred to Lund University Hospital 1993-2002. Aborted fetuses with CDH from a nation-wide Icelandic abort-registry were also included. RESULTS: In Iceland, 19 out of 23 children with CDH were diagnosed < 24 hours from delivery, one with associated anomalies. Eight fetuses were diagnosed prenatally and seven of them aborted, three having isolated CDH at autopsy. In Iceland, 15 of 18 children operated on survived surgery (83% operative survival). In Lund 28 children were treated with surgery, 23 of them diagnosed early after birth or prenatally. Four children did not survive surgery (86% operative survival) and 9 (31%) had associated anomalies. All the discharged children treated in Iceland and Lund are alive, 3-22 years postoperatively. CONCLUSION: CDH is a serious anomaly where morbidity and mortality is directly related to other associated anomalies and pulmonary hypoplasia. However, majority of CDH patients do not have other associated anomalies. In spite of improved surgical results (operative mortality < 20%), a large proportion of pregnancies complicated with CDH are terminated. We conclude that the improved survival rate after corrective surgery must be emphasized when giving information to parents regarding abortion of fetuses with a prenatally diagnosed CDH.en
dc.language.isoenen
dc.publisherThe Finnish Surgical Societyen
dc.relation.urlhttp://www.fimnet.fi/sjs/articles/SJS12008-71.pdfen
dc.subject.meshHernia, Diaphragmaticen
dc.subject.meshIcelanden
dc.subject.meshAbortion, Induceden
dc.subject.meshPrenatal Diagnosisen
dc.subject.meshInfant, Newbornen
dc.titleCongenital diaphragmatic hernia: improved surgical results should influence abortion decision makingen
dc.typeArticleen
dc.contributor.departmentDepartment of Cardiothoracic surgery, Landspitali University Hospital, Reykjavik, Iceland. tomasgud@landspitali.isen
dc.identifier.journalScandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Societyen

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