Objectives To review our NICU and surgical experience of all cases of CDH that was admitted to our hospital in last 10 years. To identify the risk factors for morbidity and mortality.
Setup Makassed Charitable Hospital, main tertiary hospital for Palestinian Territories (West Bank, Gaza and East Jerusalem).
Material and methods Retrospective Review of all cases of CDH admitted to our NICU between January 2003 and December 2013. Data about: Antenatal diagnosis, gestational age, birth weight, Apgar score, Blood gas at delivery, time of surgery, finding at surgery, ventilation days, mortality outcome and several other items were recorded and analysed. Primary outcome was: mortality, total days of ventilation and total days of Oxygen requirement.
Results Thirty three (n = 33) cases of CDH were reviewed. Twenty two cases were inborn (67%). Mortality was 10 cases (30%). Twenty three cases were discharged home alive and off oxygen therapy (70%). Better survival rate after 2009 (77% Vs 63%) this could be due to gentle ventilation strategies, better use of antenatal ultrasound for diagnosis. Lower mortality and less ventilation days were significantly associated with lower initial PaCO2 (p < 0.001) and higher PH (p < 0.001) and higher Gestational age (P 0.05). Presence of liver and/or spleen as part of hernia contents correlates negatively with the primary outcome (p < 0.05).
Conclusion This is the first study that outlines the mortality and morbidity and their risk factors in Palestinian Territories with no ECMO is used demonstrating fairly good outcome with gentle ventilation strategies and antenatal diagnosis.