ABSTRACT

Objective

Congenital diaphragmatic hernia is a congenital defect with a high mortality rate due to developmental defect of the diaphragm which causes intra-abdominal organs to be located in the thorax. Right-sided hernia, male gender, liver and stomach herniation, and degree of pulmonary hypoplasia are associated with mortality. In our study, we aimed to evaluate the factors related to mortality in diaphragmatic hernias.

Methods

We retrospectively analysed the patients who were followed up with a diagnosis of congenital diaphragmatic hernia between December 2021 and March 2025. We examined the factors affecting mortality by comparing the demographic characteristics and postnatal findings of the patients.

Results

A total of 30 congenital diaphragmatic hernias were evaluated. Twenty-one of the patients were operated, 9 patients died within the first 24 hours due to lack of cardiovascular stability. While 70% (n=21) of the patients died, 30% (n=9) survived. A lactate value of 2.3 mmol/L [area under the curve (AUC): 0.79, p<0.01] and a pCO₂ (AUC: 0.98, p<0.01) value above 60 mmHg in the first blood gas obtained during neonatal intensive care unit hospitalisation were found to be associated with mortality.

Conclusion

Congenital diaphragmatic hernia is a disease with high mortality and morbidity. In our study, we found that low birth weight, blood gas lactate and partial carbon dioxide values were associated with mortality. Multicentre prospective studies should be conducted to establish follow-up guidelines that will increase survival.