Passmed

Question 1

What Is the outcome of a patinet with congential diaphragmatic hernia dependant onn?

Answer 1

The outcome or prognosis of a patient with CDH is largely dependent on 2 factors
* (1) Liver position
* (2) Lung-to-head ratio

If the liver has herniated into the chest, the disease is more severe and there is lower chance of survival.
The lung-to-head ratio is a numeric estimate of the size of the foetal lungs, dependent on the amount of lung visible. A ratio >1.0 reflects a better outcome.

Question 2

Why are glucocorticoids given to prevent RDS?

Answer 2

Natural maternal glucocorticosteroids are very important for surfactant production in the foetus, and therefore synthetic steroids are the first line agents for preventing NRDS in pregnancies at risk of pre-term birth. Tocolytics are agents that can be used to suppress pre-term labour, however they are not routinely used. Since administration of maternal steroids takes one to two days to increase surfactant levels, tocolytics can be considered in certain situations to buy time.