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Controversies in the management of severe congenital diaphragmatic hernia

Enrico Danzer1, Holly L Hedrick1

  • 1The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

Seminars in Fetal & Neonatal Medicine
|December 3, 2014
PubMed

Insights

Severe congenital diaphragmatic hernia (CDH) is a complex condition despite advances in perinatal care. Addressing this challenge requires collaborative multicenter trials and innovative therapies for better outcomes.

Area of Science:

  • Perinatal Medicine
  • Pediatric Surgery
  • Neonatology

Background:

  • Severe congenital diaphragmatic hernia (CDH) continues to pose significant challenges in perinatal care.
  • Despite progress, numerous aspects of CDH management remain controversial.

Purpose of the Study:

  • To highlight the multifaceted controversies in the clinical management of severe congenital diaphragmatic hernia.
  • To emphasize the need for collaborative research and innovative therapies.

Main Methods:

  • Review of current clinical practices and controversies in severe CDH management.
  • Discussion of various treatment modalities including fetal intervention, ventilation, ECMO, and surgical approaches.

Main Results:

  • Significant debate exists regarding the definition of severe CDH (prenatal and postnatal criteria).
  • Controversies span fetal surgical intervention, mechanical ventilation, pulmonary hypertension management, extracorporeal membrane oxygenation (ECMO), surgical techniques, and long-term follow-up.

Conclusions:

  • Breakthroughs in severe CDH care necessitate shared experiences and institutional collaboration.
  • Well-designed multicenter clinical trials are essential for advancing innovative therapies and improving patient outcomes.

Keywords:
Clinical managementCongenital diaphragmatic herniaPrenatal diagnosisPulmonary hypertensionVentilation

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