Congenital diaphragmatic hernia: clinical and hospital aspects in a maternal and child reference hospital in the Amazon region

ABSTRACT The aim of this study is to analyze the clinical and hospital profile of newborns diagnosed with Congenital Diaphragmatic Hernia (CDH) from 2008 to 2018 in a maternal and child reference hospital. It is a cross-sectional and descriptive analytical study, which mainly included data from medical records with the codes Q79.0, Q79.1, J98.6, K44 and K44.0 of the International Classification of Diseases (ICD-10). The exclusion criteria of medical records were the diagnosis of other types of diaphragmatic hernia, without the congenital aspect; hospitalization in units that were not Neonatal ICUs; and the age at admission equal to or greater than 29 days. A total of 25,602 records were analyzed, of which 14 corresponded to CDH. The gender involvement was 71.43% male (10 cases) and 28.57% female (4), with 21.34% of Bochdalek-type CDH located on the right (3) and 78.57% on the left (11). All newborns in this study underwent invasive mechanical ventilation (IMV) 9.21 ± 5.55 days. Surgery was indicated in 11 cases (78.57%), with thoracotomy access routes in four (36.36%) and subcostal laparotomy in seven (63.64%), all using a chest tube homolateral to the hemithorax. The total hospital stay was 19.42 ± 15.36 days. There was an improved discharge evolution in eight patients (57.14%) and the death of six (42.86%), with ages around 6.19 ± 4.79 days, with no follow-up of neuropsychomotor development afterwards. There were low incidences of cases per year, the gender involvement, the associated malformations and the IMV time were similar to other populations in the world.