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Prenatal diagnosis of congenital diaphragmatic hernia with predictors of mortality
D T Wilcox1, M S Irish, B A Holm
1Department of Paediatric Surgery, Great Ormond Street Children's Hospital, NHS Trust, London, United Kingdon.
Insights
Congenital diaphragmatic hernia (CDH) is increasingly diagnosed prenatally. Accurate prognostic indicators are crucial for guiding fetal therapy and improving survival rates for babies with CDH.
Area of Science:
- Medical imaging
- Fetal medicine
- Neonatal surgery
Background:
- Congenital diaphragmatic hernia (CDH) diagnosis has evolved since the 1970s.
- Advancements in ultrasound technology enable earlier and more frequent detection of CDH.
- Early diagnosis opens possibilities for in utero interventions.
Purpose of the Study:
- To discuss the evolution of antenatal diagnosis of CDH.
- To highlight the importance of accurate prognostic indicators for fetal therapy.
- To review current approaches in managing CDH antenatally.
Main Methods:
- Review of historical diagnostic trends in CDH.
- Analysis of the impact of improved ultrasound resolution.
- Discussion of prognostic factors influencing CDH outcomes.
Main Results:
- CDH detection rates have increased with technological progress.
- Earlier gestational age at diagnosis is now common.
- The need for reliable prognostic tools is emphasized due to a 50% survival rate.
Conclusions:
- Improved antenatal ultrasound enhances CDH detection and timing.
- Accurate prognostic indicators are essential for effective antenatal management of CDH.
- Further research into prognostic markers can optimize in utero treatment strategies.
Abstract:
Since the late 1970s, congenital diaphragmatic hernia (CDH) has been diagnosed antenatally by ultrasound. With improvements in ultrasound resolution, CDH is being diagnosed more frequently and at an earlier stage in gestation. This provides an opportunity to administer in utero therapy to the fetus. As 50% of babies born with CDH survive, it is imperative that accurate prognostic indicators are available to guide antenatal therapy. Antenatal diagnosis and prognostic indicators are discussed.