Management ed outcome dell'ernia diaframmatica congenita: casistica dal 2000 al 2013

Prenatal diagnosis of congenital diaphragmatic hernia (CDH) is nowdays feasible by ultrasound, during the routine antenatal care appointments. Prompt ultrasound detection of fetuses affected by CDH is very important in order to properly manage these cases, according to specific protocols. These patients need to be redirected to referral centers, where the diagnosis could be confirmed, counselled and managed both during pregnancy and after birth by a multidisciplinary dedicated team. This approach has a positive impact on the outcome, as CDH is a severe malformation, and its prognosis is poorer if it remains undetected or mismanaged. Our aim is to retrospectively analyse all the cases of babies affected by CDH, born in the Parma University Hospital, from January 2000 to December 2013, and to observe if a prompt prenatal ultrasound diagnosis would affect the neonatal outcome. An early detection of CDH allows the clinicians to optimize the management of the patients, referring them to centers that could provide for extensive counseling, psichological support and further prenatal investigations such as accurate 2D ultrasound, 3D ultrasound, fetal MRI, CGH array, fetal endoscopic tracheal occlusion (FETO) and postnatal specialist surgery and care. Our results show this approach improves the survival rate of these patients, up to 70-90%.