What prognostic signs indicate a more severe congenital diaphragmatic hernia?

Liver herniation and right-sided lesions significant indicators of more severe congenital diaphragmatic hernia (CDH) due to the anatomical implications they present. In congenital diaphragmatic hernia, the diaphragm does not fully form, allowing abdominal organs to move into the thoracic cavity.

When a right-sided CDH occurs, it is generally associated with more serious respiratory complications compared to a left-sided lesion. This is due to the liver being larger and occupying a significant space in the abdominal cavity, causing more substantial displacement of the lung and heart on the right side. Consequently, this can lead to underdeveloped (hypoplastic) lungs, which directly affects the ability of the newborn to breathe effectively after birth.

In addition, liver herniation indicates greater severity as the liver is usually contained within the abdominal cavity. When the liver is displaced into the thorax, it not only signifies an extensive hernia but also suggests a greater involvement of thoracic structures, further compromising lung development and function. The combination of liver herniation with a right-sided lesion thus portends a poorer prognosis, often associated with higher mortality rates and increased need for intervention shortly after delivery.

On the contrary, while other options may include factors like abdominal circumference