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Transuterine Fetal Tracheal Occlusion Model in Mice
Published on: February 5, 2021
Fetal imaging and therapy for CDH-Current status
Titilayo Oluyomi-Obi1, Tim Van Mieghem2, Greg Ryan2
1Section of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, University of Calgary, 1403 29 Street NW, Calgary, Alberta.
Insights
Congenital diaphragmatic hernia (CDH) can be predicted using antenatal ultrasound. Fetuses identified may benefit from prenatal interventions like fetoscopic tracheal occlusion, improving survival rates.
Area of Science:
- Medical Imaging
- Fetal Surgery
- Neonatal Medicine
Background:
- Congenital diaphragmatic hernia (CDH) involves abdominal organs herniating into the fetal chest.
- This herniation leads to pulmonary hypoplasia and hypertension, major causes of neonatal mortality.
- Improved antenatal ultrasound screening aids in predicting postnatal outcomes.
Purpose of the Study:
- To identify fetuses with CDH who could benefit from prenatal intervention.
- To review advancements in fetal surgery for CDH.
- To present antenatal imaging techniques for risk stratification.
Main Methods:
- Review of antenatal imaging approaches for CDH.
- Evaluation of fetoscopic tracheal occlusion in a randomized controlled trial.
- Analysis of the evolution of fetal surgical techniques for CDH.
Main Results:
- Antenatal imaging can identify fetuses at high risk for CDH complications.
- Fetoscopic tracheal occlusion is under investigation as a prenatal therapy.
- Improved prediction allows for targeted prenatal interventions.
Conclusions:
- Antenatal imaging is crucial for identifying fetuses with CDH who may benefit from intervention.
- Fetal surgery, including fetoscopic tracheal occlusion, offers potential for improved outcomes in CDH.
- Advances in prenatal diagnosis and therapy are critical for reducing CDH-related neonatal mortality.
Abstract:
In congenital diaphragmatic hernia (CDH), herniation of the abdominal organs into the fetal chest causes pulmonary hypoplasia and pulmonary hypertension, the main causes of neonatal mortality. As antenatal ultrasound screening improves, the risk of postnatal death can now be better predicted, allowing for the identification of fetuses that might most benefit from a prenatal intervention. Fetoscopic tracheal occlusion is being evaluated in a large international randomized controlled trial. We present the antenatal imaging approaches that can help identify fetuses that might benefit from antenatal therapy, and review the evolution of fetal surgery for CDH to date.
