A Mirza, SH Mansoor.
Congenital Diaphragmatic Hernia : Don`t haste Surgery.
Ann King Edward Med Uni Jan ;3(3):51-3.

The management of congenital diaphragmatic hernia (CDH) in 12 neonates who had the onset of symptoms in toe first 24 hours of birth was studied prospectively. The aim of study was to assess the efficacy of prior stabilization by conventional medical therapy and determine the optimum time for successful surgery. Arterial blood gas analysis showed pH below 7 in 5(41.7%) neonates, between 7 and 7.2 in 3 (25%) and more than 7.2 in 4 (33.3%) cases. Arterial p02 ways less than 40 mmHg in 4(33.3%) cases, between 40 and 88 mmHg in 6(50%) and more than 80 mmHg in 2(16.6%) cases. The best pH obtained during stabilization period was 7 to 7.2 in 3(25%) and more than 7.2 in 9 (75%) cases whereas best possible pot obtained was between 70-80 mnHg in 2 (16.6%), cases and above 80 mmHg in 10 (83.3%) cases. Mean time period for prior stabilization was 36.2 hours. Mortality rate was 41.7% in neonates stabilize& preoperatively whereas it was 93.4% where earlier policy of urgent surgery was adopted. the authors recommend that prior stabilization followed by delayed surgery results in a, survival rate superior to at associated with early operation in neonates with CDH.

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