Congenital Diaphragmatic Hernia (CDH). The CWMH Experience 2005-2011

Incidence of 40-50% of patients with CDH having associated anomalies. The most important in terms of prognosis is congenital cardiac anomalies — ventricular septal defects, aortic arch obstruction and univentricular anatomy make up the majority of these. 6'7There is no predilection between the sexes. Recent reports on CDH show a range in mortality rate of 8790/0.8
In the Pacific region there has been no documented evidence of its incidence. In Fiji, to date the incidence of CDH is also unknown as are the outcomes of these individuals. The majority of cases are diagnosed at the three divisional hospitals, with some being transferred to Colonial War Memorial (CWM) Hospital for further management.
Being involved with two CDH cases intra-operatively at CWM Hospital with mixed outcomes made me question what contributed to these outcomes. The purpose of this study was to determine what attributes contributed to babies born with CDH surviving (or not) in our setting and in doing so also highlight the demographic makeup of this group of patients. Other objectives of the study were to review the surgical intervention performed on those that underwent surgical intervention and to try and determine what the outcome may have been in terms of survival if these infants were born at Level Ill or IV intensive care units in developed countries.