INoEA 2025 7th International Conference on Esophageal Atresia & 11th International PAAFIS Symposium & Aerodigestive Society Meeting

Background: Neonates with congenital diaphragmatic hernia (CDH) experience significant morbidity and mortality. The treatment methods, along with prenatal and postnatal factors, are believed to impact outcomes. However, data from developing countries are scarce.

Aim: This study aimed to examine the management and outcomes of CDH and identify prenatal and postnatal factors that affect survival.

Material and Methods: A retrospective review was conducted on neonates with CDH admitted to Fattouma Bourguiba University Hospital from January 2010 to December 2023. The study included demographic data, prenatal and postnatal factors, birth details, management strategies, and outcomes. Survival rates were the primary outcome measure.

Results: A total of 51 patients with CDH were included in the study. Fifty-two percent were male, and 13.2% were premature. Antenatal diagnosis was made in 39.2% of cases at a mean gestational age of 29.1 weeks using ultrasound, with MRI in 29.4%. Hydramnios was present in 7 cases, and additional anomalies were found in 7 patients. All patients developed respiratory distress, and 57.9% required intubation. Right-sided CDH occurred in 21.6%, and left-sided in 78.4%. The diagnosis was established at a mean age of 9.6 hours. Eleven percent of patients died before surgery. Post-operative complications included nosocomial infections (69.7%), pneumothorax (42.4%), and pulmonary arterial hypertension (33.3%). The mortality rate was 39.2%. Six deaths occurred within the first 72 hours of life. A favorable Apgar score at 5 minutes (p = 0.02) and FiO2 <50% at 24 hours (p = 0.01) were significantly associated with survival.

Conclusion: The study highlights the high morbidity and mortality associated with CDH in neonates. Early diagnosis, favorable Apgar scores, and oxygen management significantly improve survival outcomes.