Congenital diaphragmatic hernia: clinical and hospital aspects in a maternal and child reference hospital in the Amazon region
DOI:
https://doi.org/10.1590/1809-2950/20010627042020Keywords:
Congenital Diaphragmatic Hernias, NewbornAbstract
The aim of this study is to analyze the clinical and hospital profile of newborns diagnosed with Congenital Diaphragmatic Hernia (CDH) from 2008 to 2018 in a maternal and child reference hospital. It is a cross-sectional and descriptive analytical study, which mainly included data from medical records with the codes Q79.0, Q79.1, J98.6, K44 and K44.0 of the International Classification of Diseases (ICD-10). The exclusion criteria of medical records were the diagnosis of other types of diaphragmatic hernia, without the congenital aspect; hospitalization in units that were not Neonatal ICUs; and the age at admission equal to or greater than 29 days. A total of 25,602 records were analyzed, of which 14 corresponded to CDH. The gender involvement was 71.43% male (10 cases) and 28.57% female (4), with 21.34% of Bochdalek-type CDH located on the right (3) and 78.57% on the left (11). All newborns in this study underwent invasive mechanical ventilation (IMV) 9.21 ± 5.55 days. Surgery was indicated in 11 cases (78.57%), with thoracotomy access routes in four (36.36%) and subcostal laparotomy in seven (63.64%), all using a chest tube homolateral to the hemithorax. The total hospital stay was 19.42 ± 15.36 days. There was an improved discharge evolution in eight patients (57.14%) and the death of six (42.86%), with ages around 6.19 ± 4.79 days, with no follow-up of neuropsychomotor development afterwards. There were low incidences of cases per year, the gender involvement, the associated malformations and the IMV time were similar to other populations in the world.
Downloads
References
Quinney M, Wellesley H. Anaesthetic management of
patients with a congenital diaphragmatic hernia. BJA Educ.
;18(4):95-101. doi: 10.1016/j.bjae.2018.01.001
Zhu Q, High FA, Zhang C, Cerveira E, Russell MK, Longoni M,
et al. Systematic analysis of copy number variation associated
with congenital diaphragmatic hernia. Proc Natl Acad Sci USA.
;115(20):5247-52. doi: 10.1073/pnas.1714885115
Barbosa BML, Rodrigues AS, Carvalho MHB, Bittar RE, Francisco
RPV, Bernardes LS. Spontaneous prematurity in fetuses with
congenital diaphragmatic hernia: a retrospective cohort study
about prenatal predictive factors. BMC Pregnancy Childbirth.
;8(1):27. doi: 10.1186/s12884-017-1652-6
Ferreira HC, Arakaki VSNM. Hérnia diafragmática congênita:
cuidados ao manuseio pela fisioterapia. In: Martins J, Schivinski C,
Ribeiro SNS, organizadores. PROFISIO: Programa de atualização
em fisioterapia pediátrica e neonatal: cardiorrespiratória e
terapia intensiva. Porto Alegre: Artmed; 2018. p. 79-114.
Lauriti G, Zani-Ruttenstock E, Catania VD, Antounians L,
Chiesa PL, Pierro A, et al. Open versus laparoscopic approach
for Morgagni’s hernia in infants and children: a systematic
review and meta-analysis. J Laparoendosc Adv Surg Tech.
;28(7):888-93. doi: 10.1089/lap.2018.0103
Al-Iede MM, Karpelowsky J, Fitzgerald DA. Recurrent
diaphragmatic hernia: modifiable and non-modifiable risk
factors. Pediatr Pulmonol. 2016;51(4):394-401. doi: 10.1002/
ppul.23305
Partridge EA, Peranteau WH, Herkert L, Rendon N, Smith
H, Rintoul NE, et al. Right- versus left-sided congenital
diaphragmatic hernia: a comparative outcomes analysis. J Pediatr
Surg. 2016;51(6):900-2. doi: 10.1016/j.jpedsurg.2016.02.049
Long AM, Bunch KJ, Knight M, Kurinczuk JJ, Losty PD. Early
population-based outcomes of infants born with congenital
diaphragmatic hernia. Arch Dis Child Fetal Neonatal Ed.
;103(6):F517-22 doi: 10.1136/archdischild-2018-314820
Reuter C, Souza J, Maurici R. Hérnia diafragmática congênita:
fatores associados ao óbito. Arq Catarin Med. 2019 [citado em
mar. 2021];48(1):82-93. Disponível em: http://www.acm.org.
br/acm/seer/index.php/arquivos/article/view/388
Chandrasekharan PK, Rawat M, Madappa R, Rothstein DH,
Lakshminrusimha S. Congenital diaphragmatic hernia: a review.
Matern Health Neonatol Perinatol. 2017;3(1):6. doi: 10.1186/
s40748-017-0045-1
Nakwan N, Jain S, Kumar K, Hosono S, Hammoud M, Elsayed
YY, et al. An Asian multicenter retrospective study on persistent
pulmonary hypertension of the newborn: incidence, etiology,
diagnosis, treatment and outcome. J Matern Fetal Med.
;33(12):2032-7. doi: 10.1080/14767058.2018.1536740
Núñez Cerezo V, Rumo Muñoz M, Encinas JL, Elorza Fernández
MD, Herrero B, Antolín L, et al. Estudio de la hipertensión
pulmonar y la clínica respiratoria a largo plazo en los niños
con hernia diafragmática congénita. Cir Pediatr. 2018 [citado
em 5 mar. 2021];31:76-80. Disponível em: https://www.secipe.
org/coldata/upload/revista/2018_31-2_76-80.pdf
Harting MT. Congenital diaphragmatic hernia-associated
pulmonary hypertension. Semin Perinatol. 2020;44(1):147-
doi: 10.1053/j.semperi.2019.07.006
Coffman ZJ, McGahren ED, Vergales BD, Saunders CH, Vergales
JE. The effect of congenital diaphragmatic hernia on the
development of left-sided heart structures. Cardiol Young.
;29(6):813-8. doi: 10.1017/S1047951119000891
Cua CL, Haque U, Santoro S, Nicholson L, Backes CH. Differences
in mortality characteristics in neonates with Down’s syndrome.
J Perinatol. 2017;37(4):427-31. doi: 10.1038/jp.2016.246
Kalanj J, Salevic P, Rsovac S, Medjo B, Antunovic SS, Simic D.
Congenital diaphragmatic hernia: a Belgrade single center
experience. J Perinat Med. 2016;44(8):913-8. doi: 10.1515/
jpm-2015-0333
Okuyama H, Usui N, Hayakawa M, Taguchi, T. Appropriate timing
of surgery for neonates with congenital diaphragmatic hernia:
early or delayed repair? Pediatr Surg Int. 2016;33(2):133-8.
doi: 10.1007/s00383-016-4003-1
Weems MF, Jancelewicz T, Sandhu HS. Congenital diaphragmatic
hernia: maximizing survival. Neoreviews. 2016;17(12):e705-e718.
doi: 10.1542/neo.17-12-e705
Snoek KG, Reiss I, Grenough A, Capolupo I, Urlesberger B,
Wessel L, et al. Standardized postnatal management of infants
with congenital diaphragmatic hernia in Europe: The CDH
EURO Consortium Consensus – 2015 Update. Neonatology.
;110:66-74. doi: 10.1159/000444210
Morini F, Valfrè L, Bagolan P. Long-term morbidity of congenital
diaphragmatic hernia: a plea for standardization. Semin Pediatr
Surg. 2017;26(5):301-10. doi: 10.1053/j.sempedsurg.2017.09.002
Russell KW, Barnhart DC, Rollins MD, Hedlund G, Scaife ER.
Musculoskeletal deformities following repair of large congenital
diaphragmatic hernias. J Pediatr Surg. 2014;49(6):886-9.
doi: 10.1016/j.jpedsurg.2014.01.018
Kumar VHS, Dadiz R, Koumoundouros J, Guilford S,
Lakshminrusimha S. Response to pulmonary vasodilators in
infants with congenital diaphragmatic hernia. Pediatr Surg Int.
;34(7):735-42. doi: 10.1007/s00383-018-4286-5
Leeuwen L, Mous DS, van Rosmalen J, Olieman JF, Andriessen L,
Gischler SJ, et al. Congenital diaphragmatic hernia and growth
to 12 years. Pediatrics. 2017;140(2):e20163659. doi: 10.1542/
peds.2016-36
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Lorenna Costa Malaquais, George Alberto da Silva Dias, Katiane da Costa Cunha, Natalia Velia Silva Cei, Elineth da Conceição Braga Valente, André Gustavo Moura Guimarães
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
