Most important prognostic factor in the condition shown in the picture below is ?
A. Pulmonary hypertension.
B. Size of hernia.
C. Timing of surgery.
D. Gestational age.
The condition shown in the picture above represents congenital diaphragmatic hernia.
- Compression of the lung results in pulmonary hypoplasia involving both lungs, with the ipsilateral lung being the most affected.
- In addition to the abnormal airway development, the pulmonary vasculature is distinctly abnormal in that the medial muscular thickness of the arterioles is excessive and extremely sensitive to the multiple local and systemic factors known to trigger vasospasm.
Thus, the two main factors that affect morbidity and mortality are
- Pulmonary hypoplasia and
- Pulmonary hypertension.