Related Experiment Video
Updated: May 14, 2026
Transuterine Fetal Tracheal Occlusion Model in Mice
Published on: February 5, 2021
Management of prenatally diagnosed congenital diaphragmatic hernia
1Perelman School of Medicine at the University of Pennsylvania, The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. Hedrick@email.chop.edu
Insights
Congenital diaphragmatic hernia (CDH) is a severe condition impacting infant lungs. While neonatal care improves survival, severe cases still face high risks, and prenatal interventions need more randomized trial evidence.
Area of Science:
- Neonatology
- Pediatric Surgery
- Fetal Medicine
Background:
- Congenital diaphragmatic hernia (CDH) is a complex congenital anomaly with variable severity.
- Pulmonary hypoplasia and hypertension significantly influence CDH outcomes.
- Despite advances in neonatal care, severe CDH cases have high mortality and morbidity.
Purpose of the Study:
- To review the current status of prenatal predictors and interventions for congenital diaphragmatic hernia.
- To evaluate the evidence for prenatal interventions compared to standard postnatal therapy.
- To highlight the need for long-term follow-up resources for CDH survivors.
Main Methods:
- Review of randomized trials comparing prenatal intervention with postnatal therapy for CDH.
- Analysis of non-randomized reports on fetoscopic endoluminal tracheal occlusion (FETO) and release.
- Discussion of the evolution of prenatal predictors for CDH severity.
Main Results:
- Randomized trials have not demonstrated a benefit of prenatal intervention over standard postnatal care for CDH.
- Recent non-randomized studies on FETO show promising results but require further validation.
- Prenatal predictors for CDH have been refined but require prospective validation.
Conclusions:
- Prenatal interventions for CDH should not be widely adopted until efficacy is proven in well-designed randomized trials.
- Fetoscopic endoluminal tracheal occlusion (FETO) shows potential but needs more robust evidence.
- Increased survival rates necessitate comprehensive long-term follow-up and support systems for CDH survivors.
Abstract:
Congenital diaphragmatic hernia (CDH) is a congenital anomaly that presents with a broad spectrum of severity that is dependent upon components of pulmonary hypoplasia and pulmonary hypertension. While advances in neonatal care have improved the overall survival of CDH in experienced centers, mortality and morbidity remain high in a subset of CDH infants with severe CDH. Prenatal predictors have been refined for the past two decades and are the subject of another review in this issue. So far, all randomized trials comparing prenatal intervention to standard postnatal therapy have shown no benefit to prenatal intervention. Although recent non-randomized reports of success with fetoscopic endoluminal tracheal occlusion (FETO) and release are promising, prenatal therapy should not be widely adopted until a well-designed prospective randomized trial demonstrating efficacy is performed. The increased survival and subsequent morbidity of CDH survivors has resulted in the need to provide resources for the long-term follow up and support of the CDH population.
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
01:19Mitral Valve Prolapse III: Nursing Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:27Mitral Stenosis IV: Nursing Management
01:21Rheumatic Heart Disease III: Medical Management
01:29Cardiomyopathy V: Interprofessional Care