Guidelines for the Medical Management of Congenital Diaphragmatic Hernia: Implications for Resource-limited Settings

For neonates with congenital diaphragmatic hernia (CDH), the challenges start immediately after birth. Respiratory distress and hemodynamic compromise set in with the herniation of the contents of the abdomen into the thoracic cavity. Though definitive surgical correction and long-term follow-up are required, the immediate postnatal stabilization is of paramount importance. Depending on the extent of herniation, the associated physiological impairment is variable. With extensive research over the past few decades and a better understanding of the disease physiology, coupled with newer modalities in management, various multi-institutional bodies have proposed clinical practice guidelines. This study aims to compare these guidelines for the management of CDH neonates and to understand their implications for resource-poor settings.