Which of the following is the least important prognostic factor in congenital diaphragmatic hernia ?
(A) Pulmonary Hypertension (B) Delay in emergent surgery (C) Size of defect (D) Gestational age at diagnosis
(B) Timing of surgical repair has gradually shifted from an emergency repair, to a policy of stabilization using a variety of ventilatory strategies prior to operation. •
Current recommendation is to adopt a conservative approach and delay surgical repair of the CDH until the infant stablizes from a hemodynamic and respiratory point of view.

Prognostic factors in CDI-1 

Prognostic factors can be divided into:

(A) Primary prognostic factors (Pathophysiological)

These are the most important prognostic factor which affect morbidity and mortility.
These factors are:


Pulmonary hypoplasia (most important)
Pulmonary hypertension (2nd most important)

(B) Secondary or relative predictors (diagnostic/clinical)

These poor prognostic factors are:

(a)      tinatal

Detection at an early gestational age (<24 wks)
Associated extradiaphragmatic congenital anomalies
Liver herniation into thorax (Liver above diaphragm)


Stomach herniationinto thorax (Stomach above diaphragm)
Presence of polyhydraminios
Small lung to head circumference ratio (LI-IR ratio)
Small fetal abdominal circumference (< than 5th percentile)

(b) Postnatal

Early age (< 6 hours) of presentation
PG, and PCO, unresponsive to ventilation
Need for extracorporeal membrane oxygenation (ECM0)

(c) Side of defect
(i) Right sided defect