Termination of pregnancy after a prenatal diagnosis of congenital diaphragmatic hernia: Factors influencing the parental decision process

Emily J.J. Horn-Oudshoorn, Nina C.J. Peters, Arie Franx, Alex J. Eggink, Suzan C.M. Cochius-den Otter, Irwin K.M. Reiss, Philip L.J. DeKoninck*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)
51 Downloads (Pure)

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 includes all prenatally detected CDH cases born between January 2009 and 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. Twenty 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 the presence of additional abnormalities. This emphasises the importance of early referral to expertise centres for detailed evaluation and multidisciplinary counselling.

Original languageEnglish
Pages (from-to)95-101
Number of pages7
JournalPrenatal Diagnosis
Volume43
Issue number1
Early online date28 Nov 2022
DOIs
Publication statusPublished - Jan 2023

Bibliographical note

Funding Information:
EJJHO and PLJD are supported by a grant from Sophia Children's Hospital Foundation (SSWO, grant S19‐12).

Publisher Copyright:
© 2022 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.

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