Background

Pulmonary hypoplasia is common in the perinatal period and a significant cause of death in newborn infants. Definitive diagnosis is by histopathology. Clinical diagnosis and management is often challenging. There are no studies describing outcomes of the neonates with clinically suspected pulmonary hypoplasia.

Objectives

Outcomes of preterm and term infants with clinical diagnosis of pulmonary hypoplasia

Methods

Retrospective observational study over a period of 10 years from January 2009 to December 2018. Data was collected from Badger database (Neonatal patient record database) on gestational age, birth weight, ventilator support, use of nitric oxide, CLD ( Chronic Lung Disease), mortality and two year neurodevelopmental outcome

Results

Total number of infants identified with clinical diagnosis of pulmonary hypoplasia: 27; with mortality of 19/26 (73%), survival of 7/26 (26%) 1 outcome unknown. The proportion of infants with associated anomalies and survival: anhydramnios/oligohydramnios due to PROM (Prolonged Rupture of Membranes) (11/5), skeletal dysplasia (2/0), renal anomalies (7/1), multiple congenital anomalies (5/0), postnatal diagnosis of Congenital Diaphragmatic Hernia (1/1). Among the survivors 3/7 had CLD. Two year neurodevelopmental outcome showed, 2 with no or mild delay, 1 with moderate delay and none had severe delay.

Anhydramnios/ Oligohydramnios secondary to PROM: n- 11

Conclusion

In non-surgical tertiary NICU, PROM leading to anhydramnios/oligohydramnios is the most common cause for pulmonary hypoplasia. Mortality remains very high in infants born with pulmonary hypoplasia. Aggressive treatment for pulmonary hypoplasia secondary to PROM and anhydramnios/oligohydramnios is required to improve the outcomes.