Pediatric Cases
Answer:
Answer:
1. C.
2. A
3. D
Congenital diaphragmatic hernia (CDH) occurs in 1 of every 2000-3000 live births and accounts for 8% of all major congenital anomalies. It occurs more frequently on the left side and can be difficult to differentiate from a congenital cystic adenomatoid malformation. Mortality after live birth is generally reported to range from 40 to 62%. Factors leading to an adverse outcome include associated anomalies, prenatal diagnosis, prematurity, low birth weight and early pneumothorax.
The outcome in patients with a late presentation of CDH (approx 10% present after the newborn period) is very good, with low or no mortality.
The main risks associated with CDH affecting morbidity and mortality is of pulmonary hypertension and pulmonary hypoplasia. Treatment is aimed at mechanical ventilation avoiding high peak inspiratory pressures.
High frequency ventilation is sometimes used to avoid this and in extreme circumstances ECMO is required. Fetal surgery has not as yet been shown to improve survival. A delayed surgical approach that enables preoperative stabilization is important in reducing morbidity and mortality.
The outcome in patients with a late presentation of CDH (approx 10% present after the newborn period) is very good, with low or no mortality.
The main risks associated with CDH affecting morbidity and mortality is of pulmonary hypertension and pulmonary hypoplasia. Treatment is aimed at mechanical ventilation avoiding high peak inspiratory pressures.
High frequency ventilation is sometimes used to avoid this and in extreme circumstances ECMO is required. Fetal surgery has not as yet been shown to improve survival. A delayed surgical approach that enables preoperative stabilization is important in reducing morbidity and mortality.
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