Augustin G, Kovač D, Karadjole VS, Zajec V, Herman M, Hrabač P. Maternal diaphragmatic hernia in pregnancy: A systematic review with a treatment algorithm. World J Clin Cases 2023; 11(27): 6440-6454 [PMID: 37900237 DOI: 10.12998/wjcc.v11.i27.6440]
Corresponding Author of This Article
Goran Augustin, MD, MSc, PhD, Associate Professor, Doctor, Senior Scientist, Surgical Oncologist, Department of Surgery, University Hospital Centre Zagreb, Kišpatićeva 12, Zagreb 10000, Croatia. augustin.goran@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Goran Augustin, Department of Surgery, University Hospital Centre Zagreb, Zagreb 10000, Croatia
Goran Augustin, Chair of Surgery, School of Medicine University of Zagreb, Zagreb 10000, Croatia
Diana Kovač, Institute of Emergency Medicine of Dubrovnik-Neretva County, Croatian Institute of Emergency Medicine, Dubrovnik 20000, Croatia
Vesna Sokol Karadjole, Department of Gynaecology and Obstetrics, University Clinical Hospital Centre Zagreb, Zagreb 10000, Croatia
Vendy Zajec, Mislav Herman, Department of Gynaecology and Obstetrics, University Hospital Centre Zagreb, Zagreb 10000, Croatia
Pero Hrabač, Department of Biostatistics, "Andrija Štampar" School of Public Health, Zagreb 10000, Croatia
Pero Hrabač, Department of Biostatistics, School of Medicine University of Zagreb, Zagreb 10000, Croatia
Author contributions: Augustin G, Karadjole VS, and Hrabač P contributed to manuscript writing; Augustin G, Kovač D, and Zajec V contributed to data collection; Augustin G, Kovač D, Zajec V, and Herman M contributed to data analysis; Karadjole VS contributed to supervision; Hrabač P contributed to statistical analysis.
Conflict-of-interest statement: We declare that we have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Goran Augustin, MD, MSc, PhD, Associate Professor, Doctor, Senior Scientist, Surgical Oncologist, Department of Surgery, University Hospital Centre Zagreb, Kišpatićeva 12, Zagreb 10000, Croatia. augustin.goran@gmail.com
Received: June 11, 2023 Peer-review started: June 11, 2023 First decision: August 8, 2023 Revised: August 10, 2023 Accepted: August 29, 2023 Article in press: August 29, 2023 Published online: September 26, 2023 Processing time: 100 Days and 22 Hours
Core Tip
Core Tip: Diaphragmatic hernias (DH) in pregnancy are extremely rare. The average maternal age and the proportion of congenital hernias increased. Most DHs were left-sided. The number of herniated organs declined. The clinical presentation is easily confused with common chest conditions, delaying the diagnosis, and increasing maternal and fetal mortality. A working diagnosis was correct in 50%. DH type did not correlate to maternal or neonatal outcomes. Laparoscopic access increased while thoracotomy varied. Presentation of less than 3 days carried a significant risk of strangulation in pregnancy. A proposed algorithm helps manage pregnant women with maternal DH. Strangulated DH requires an emergent operation, while delivery should be based on obstetric indications.
