Prenat Diagn
. 2022 Nov 28.
doi: 10.1002/pd.6274. Online ahead of print.
Termination of pregnancy after a prenatal diagnosis of congenital diaphragmatic hernia: Factors influencing the parental decision process
Emily J J Horn-Oudshoorn 1, Nina C J Peters 2, Arie Franx 2, Alex J Eggink 2, Suzan C M Cochius-den Otter 3, Irwin K M Reiss 1, Philip L J DeKoninck 2
Affiliations expand
- PMID: 36443507
- DOI: 10.1002/pd.6274
Abstract
Objective: To evaluate the incidence of termination of pregnancies (TOP) and factors associated with the decision for TOP in prenatally detected congenital diaphragmatic hernia (CDH).
Study design: Single-centre retrospective cohort including all prenatally detected CDH cases born between January 2009-December 2021. Parental factors, such as parity, and fetal characteristics, such as disease severity, were collected. Descriptive statistics were used to present the data. Differences between terminated and continued pregnancies were analysed.
Results: The study population consisted of 278 prenatally detected CDH cases, of which 80% detected <24 weeks of gestation. The TOP-rate was 28% in cases that were detected <24 weeks of gestation. 20 continued pregnancies resulted in either intrauterine fetal demise (n=6), preterm birth <24 weeks (n=2), or comfort care after birth (n=12). The survival rate was 70% in the remaining 195 live born cases. Factors associated with the decision for TOP were additional fetal genetic or anatomical abnormalities (p<0.0001) and expected severity of pulmonary hypoplasia in left-sided CDH (p=0.0456).
Conclusion: The decision to terminate a pregnancy complicated by fetal CDH depends on the severity of pulmonary hypoplasia and presence of additional abnormalities. This emphasises the importance of early referral to expertise centres for detailed evaluation and multidisciplinary counselling. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
