[size=20px]A term infant (39 weeks gestation) is born at a tertiary care facility with an antenatally diagnosed congenital diaphragmatic hernia. Her birth weight is 1350 grams, 1-minute APGAR is 7, and 5-minute APGAR is 8. Echocardiogram demonstrates increased pulmonary vascular resistance and increased right ventricular pressure. Her cardiac architecture is otherwise normal. Chromosomal testing is also normal. Based on the Congenital Diaphragmatic Hernia Study Group (CDHSG) clinical prediction model, what is this patient’s risk profile?

 

A Low risk

 

B Intermediate risk

 

C High risk

 

D Insufficient data to determine risk profile​[/size]

C High risk

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correct answer

C High risk

 

According to the CDHSG prediction model, this infant is at high risk of mortality (with a total score of 3 points). ​

​This patient has a low birthweight (1 point), normal 5-minute APGAR (0 points), 5-minute APGAR is not missing (0 points), pulmonary hypertension (2 points), no major cardiac anomaly (0 points), and no chromosomal anomalies (0 points). According to the validation study by Bent et al., this patient would have a predicted mortality of 58.5%. If the patient had a normal birthweight, her total score would be 2 points, and her risk would be downgraded to intermediate. She would have a predicted mortality rate of 23.2%.

 

 

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Edited September 18, 20224 yr by Admin