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

Gudbjartsson, T; Gunnarsdottir, Anna LU ; Topan, C Z; Larsson, Lars Torsten LU ; Rosmundsson, Th and Dagbjartsson, A (2008) In Scandinavian Journal of Surgery 97(1). p.71-76
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
prenatal counselling, survival, surgery, incidence, congenital diaphragmatic hernia, abortion, children
in
Scandinavian Journal of Surgery
volume
97
issue
1
pages
71 - 76
publisher
Finnish Surgical Society
external identifiers
  • wos:000254267200010
  • scopus:41349087963
ISSN
1799-7267
language
English
LU publication?
yes
id
3f4f3413-62c5-4c67-9982-f1e351fe520a (old id 1183170)
alternative location
http://www.fimnet.fi/sjs/articles/SJS12008-71.pdf
date added to LUP
2008-09-02 12:22:02
date last changed
2017-01-01 04:56:53
@article{3f4f3413-62c5-4c67-9982-f1e351fe520a,
  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 &lt; 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 &lt; 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.},
  author       = {Gudbjartsson, T and Gunnarsdottir, Anna and Topan, C Z and Larsson, Lars Torsten and Rosmundsson, Th and Dagbjartsson, A},
  issn         = {1799-7267},
  keyword      = {prenatal counselling,survival,surgery,incidence,congenital diaphragmatic hernia,abortion,children},
  language     = {eng},
  number       = {1},
  pages        = {71--76},
  publisher    = {Finnish Surgical Society},
  series       = {Scandinavian Journal of Surgery},
  title        = {Congenital diaphragmatic hernia: Improved surgical results should influence abortion decision making},
  volume       = {97},
  year         = {2008},
}