12:41am Friday 13 December 2019

Texas Children's Fetal Center study shows perinatal management improves outcomes for babies with congenital diaphragmatic hernia

The study is a comprehensive look at high-risk CDH cases and demonstrates that, thanks to advancements in fetal medicine, babies with the condition have a greater chance for a healthy start to life with the right prenatal evaluation and protocol-based management.

CDH is a developmental anomaly which occurs in as many as 1 in 2,500 births. In the current era, mortality rate for these patients has significantly dropped, but the cause of these improved outcomes has been unclear. In an attempt to address the impact of early management protocol for CDH, experts at Texas Children’s Fetal Center compared the outcome of patients who were evaluated prenatally (PRE group) with those who were outborn or diagnosed postnatally (POST group). While more infants in the PRE group displayed severe risk factors, the study showed extremely similar rates of survival and outcomes between the two groups – highlighting the benefits of early CDH diagnosis and treatment.

“Our work with CDH patients is extensive, and it was essential that we thoroughly document our results so that centers everywhere can realize the benefits of prenatal management,” said Dr. Oluyinka O. Olutoye, corresponding author on the study, co-director of Texas Children’s Fetal Center and associate professor, department of Pediatric Surgery at Baylor College of Medicine.

Practitioners across the country will now have a better understanding of the benefits of prenatal evaluation and multidisciplinary perinatal management for fetuses with CDH, and can use this knowledge to counsel these families, or to refer them to a center that can care for them properly at an early stage.

The study was conducted by Oluyinka O. Olutoye, M.D.; Darrell L. Cass, M.D.; Manuel A. Rodriguez, M.D.; Saif F. Hassan, M.D.; Christopher I. Cassady, M.D.; Yvette R. Johnson, M.D.; Kenneth J. Moise, M.D., Anthony Johnson, D.O.; M.D.; David A. Lazar, M.D.; Karen E. Johnson, R.N. and Bella Belleza-Bascon, R.N., and was based on 116 CDH patients, with 71 fetuses who presented in the prenatal period and 45 infants who were outborn or postnatally diagnosed at Texas Children’s Fetal Center between 2004 and 2009. The complete study, called “Impact of prenatal evaluation and protocol-based perinatal management on congenital diaphragmatic hernia outcomes” can be found in the May edition of the Journal of Pediatric Surgery.

About Texas Children’s Fetal Center
Texas Children’s Fetal Center is a national leader in the diagnosis and treatment of abnormalities in unborn and newborn infants. The physicians at Texas Children’s Fetal Center are recognized leaders in fetal medicine and fetal and neonatal surgery. As one of only four centers in the United States that provides the full spectrum of fetal therapies, including fetal intervention and fetal surgery, Texas Children’s Fetal Center is committed to providing accurate diagnosis and premier, complete treatment for pregnant women and their unborn children. For more information, visit www.fetal.texaschildrens.org.

About Texas Children’s Hospital
Texas Children’s Hospital is committed to a community of healthy children by providing the finest pediatric patient care, education and research. Renowned worldwide for its expertise and breakthrough developments in clinical care and research, Texas Children’s is nationally ranked in all ten subspecialties in U.S.News & World Report‘s list of America’s Best Children’s Hospitals. Texas Children’s also operates the nation’s largest primary pediatric care network, with more than 40 offices throughout the greater Houston community. Texas Children’s has embarked on a $1.5 billion expansion, Vision 2010, which includes the Jan and Dan Duncan Neurological Research Institute, a comprehensive obstetrics facility focusing on high-risk births and a community hospital in suburban West Houston. For more information on Texas Children’s Hospital, go to www.texaschildrens.org.

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