OC16.05: The factors influencing clinicians in medical decision making for fetuses with congenital diaphragmatic hernia at a tertiary referral centre

We aimed to analysis the proposal for prenatal assessment of the fetuses with congenital diaphragmatic hernia at a tertiary referral centre in Beijing. All prenatal congenital diaphragmatic hernia cases detected by ultrasound between July 2017 and December 2022 at the Beijing Obstetrics and Gynecology Hospital were included. The data were compared between the live born group and non-live born group. The characteristics of the anomalies associated with complex congenital diaphragmatic hernia cases and the O/E LHR in live born group were analysed. The maternal age, gestational age at diagnosis, genetic testing, ultrasound information, and pregnancy outcome were statistically analysed using two independent-sample t-test and χ2 square test. Univariate analysis was performed on the characteristics of these two groups, followed by multivariate analysis. A total of 105 fetuses with congenital diaphragmatic hernia, diagnosed using ultrasonography were retrospectively reviewed. Overall mortality rates of isolated and complex congenital diaphragmatic hernia cases in live born group were 34.4% and 30.0%, respectively. Antenatal diagnosis rates of congenital heart disease and increased nuchal translucency thicknesses with congenital diaphragmatic hernia were significantly different between the two groups (7% vs. 29%, p < 0.05; 2% vs. 23%, p < 0.05). In the multivariate analysis, the risk factors independently associated with pregnancy termination were gestational age at diagnosis (odds ratio [OR] 0.887, 95% CI 0.802–0.981, p < 0.05) and congenital heart disease (OR 0.158, 95% CI 0.030–0.841, p < 0.05). We call for a more positive advice for parents of fetuses with isolated and non-critical complex congenital diaphragmatic hernia based on an increased survival rate. Congenital heart disease were the most frequent anomalies observed in both groups. The likelihood of termination of pregnancy is increased by early detection and combined with congenital heart disease.