Related Experiment Video

Updated: Jun 25, 2026

Transuterine Fetal Tracheal Occlusion Model in Mice
06:31

Transuterine Fetal Tracheal Occlusion Model in Mice

Published on: February 5, 2021

The hidden mortality of congenital diaphragmatic hernia: a 20-year review

E M Brownlee1, A G Howatson, C F Davis

  • 1Department of Surgical Paediatrics, Royal Hospital for Sick Children, Yorkhill, Glasgow, Scotland. ewanbrownlee@doctors.net.uk

Journal of Pediatric Surgery
|February 24, 2009
PubMed

Insights

Congenital diaphragmatic hernia (CDH) mortality is underestimated as fetuses are excluded from survival analyses. Postmortem reviews reveal a higher incidence of CDH, particularly right-sided hernias and multiple anomalies, in fetal deaths.

Area of Science:

  • Medical research
  • Pediatric surgery
  • Fetal pathology

Background:

  • Congenital diaphragmatic hernia (CDH) survival analyses often exclude fetal deaths, masking true mortality.
  • Accurate assessment of CDH incidence and associated anomalies is crucial for understanding its impact.

Purpose of the Study:

  • To determine the hidden mortality associated with congenital diaphragmatic hernia (CDH).
  • To quantify the nature and frequency of anomalies accompanying CDH in fetal deaths.

Main Methods:

  • Retrospective review of postmortem (PM) records over a 20-year period (1986-2005).
  • Inclusion of data on live births, stillbirths, therapeutic abortions, and spontaneous abortions with CDH diagnosis.

Main Results:

  • 130 PMs with CDH were identified: 97 left-sided, 22 right-sided, 11 bilateral.
  • Associated anomalies were common (63%), with cardiac, gastrointestinal, and neural tube defects being most frequent.
  • Right-sided/bilateral hernias and multiple anomalies were more prevalent in intrauterine deaths.

Conclusions:

  • The true incidence of CDH is significantly higher than suggested by neonatal surgical data.
  • Declining postmortem rates may further underestimate CDH incidence.
  • Fetal deaths exhibit a higher proportion of right-sided/bilateral CDH and multiple congenital anomalies.
Abstract

More Related Videos

Continuous Telemetric In Utero Tracheal Pressure Measurements in Fetal Lambs05:40

Continuous Telemetric In Utero Tracheal Pressure Measurements in Fetal Lambs

Published on: December 22, 2023

Related Concept Videos

Hiatal Hernia01:25

Hiatal Hernia

A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
Pneumothorax II: Pathophysiology01:08

Pneumothorax II: Pathophysiology

Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
Atelectasis II: Pathophysiology01:10

Atelectasis II: Pathophysiology

Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through collapsed...
Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Pneumothorax-I01:26

Pneumothorax-I

A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.