Diaphragmatic Hernia Score

Predict outcomes in congenital diaphragmatic hernia (CDH) using prenatal and postnatal parameters.

Disclaimer

This scoring system synthesizes common prognostic factors for CDH. Exact survival predictions depend on institutional experience and multiple variables. Always discuss with the multidisciplinary CDH team.

Prenatal & Postnatal Parameters

Side of Hernia

Gestational Age (weeks)

Birth Weight (Kg)

APGAR at 5 min

Defect Size (CDH Study Group Classification)

Lung-to-Head Ratio (LHR)

Observed/Expected LHR (%)

Best Oxygenation Index (OI)

Additional Factors

Liver herniation (liver up)ECMO requiredAssociated major anomalies (cardiac, chromosomal)

O/E LHR Prognostic Categories

O/E LHR > 45%Mild

O/E LHR 26-45%Moderate

O/E LHR 15-25%Severe

O/E LHR < 15%Extreme

References

1. Jani J, et al. Observed to expected lung area to head circumference ratio in the prediction of survival in fetuses with isolated CDH. Ultrasound Obstet Gynecol. 2007.
2. Congenital Diaphragmatic Hernia Study Group. Estimating disease severity of CDH in the first 5 minutes of life. J Pediatr Surg. 2001.