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Congenital diaphragmatic hernia: treatment and outcomes

Andrea Badillo1, Cynthia Gingalewski2

  • 1Children's National Medical Center, 111 Michigan Avenue NW, Suite W4-200, Washington, DC 20008.

Seminars in Perinatology
|March 4, 2014
PubMed

Insights

Congenital diaphragmatic hernia (CDH) is a birth defect impacting lung development. Improved prenatal diagnosis and care enhance survival, with fetal endoscopic tracheal occlusion showing promise for severe cases.

Area of Science:

  • Pediatric Surgery
  • Neonatal Medicine
  • Developmental Biology

Background:

  • Congenital diaphragmatic hernia (CDH) is a critical birth defect where abdominal organs herniate into the chest.
  • This herniation leads to underdeveloped lungs (pulmonary hypoplasia) and high blood pressure in the lungs (pulmonary hypertension).
  • Historically, CDH has a high mortality rate, but recent advancements are improving outcomes.

Purpose of the Study:

  • To review the current understanding and management of congenital diaphragmatic hernia.
  • To highlight advancements in prenatal diagnosis and postnatal care protocols.
  • To discuss emerging fetal therapies and the long-term needs of CDH survivors.

Main Methods:

  • Review of current literature on congenital diaphragmatic hernia.
  • Analysis of outcomes based on advancements in prenatal diagnosis and standardized care.
  • Evaluation of the potential of fetal endoscopic tracheal occlusion (FETO).

Main Results:

  • Improved survival rates for CDH patients due to better prenatal diagnosis and standardized care.
  • Fetal endoscopic tracheal occlusion demonstrates potential for severe CDH cases.
  • Long-term morbidities persist in CDH survivors, necessitating ongoing management.

Conclusions:

  • Advances in care have significantly improved congenital diaphragmatic hernia survival.
  • Fetal endoscopic tracheal occlusion is a promising intervention requiring further randomized trials.
  • Long-term follow-up and early intervention are crucial for managing CDH survivors' morbidities.

Keywords:
Congenital diaphragmatic herniaLong term outcomesPostnatal treatmentPrenatal counseling

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