Post-mortem findings in fetal and neonatal congenital diaphragmatic hernia

Analyses of survival data of neonates born with congenital diaphragmatic he rnia (CDH) can be misleading. There is a hidden mortality only apparent whe n fetuses with CDH are included in the analysis. A retrospective review of all post mortems with a diagnosis of CDH in the West of Scotland over a 10- year period was carried out. Congenital anomalies were identified and heart and lung weights were compared with controls (infants dying of non-cardior espiratory causes). 70 Pm reports were studied. Major congenital anomalies were present in 53% (18/ 47 live born, 19/23 not live born). Neural tube de fects, cardiac and chromosomal anomalies were the most common. Antenatal de tection rate was 17% in live-born infants. In infants dying within the firs t week of life lung weights showed severe pulmonary hypoplasia, but heart w eights were within the normal range. Detailed antenatal scanning needs to b e considered if the detection rate for CDH is to improve in this region.