Antenatal management of congenital diaphragmatic hernia today and tomorrow

Lennart Van Der Veeken, Francesca M. Russo, Johannes Van Der Merwe, David Basurto, Dyuti Sharma, Tram Nguyen, Marie P. Eastwood, Namesh Khoshgoo, Jaan Toelen, Karel Allegaert, Philip Dekoninck, Stuart B. Hooper, Richard Keijzer, Paolo De Coppi, Jan Deprest

Research output: Contribution to journalReview ArticleResearchpeer-review

5 Citations (Scopus)

Abstract

Congenital diaphragmatic hernia is rare birth defect, which can be easily corrected after birth. The main problem is that herniation of viscera during fetal life impairs lung development, leading to a 30% mortality and significant morbidity. In isolated cases the outcome can be accurately predicted prenatally by medical imaging. Cases with a poor prognosis can be treated before birth; clinically this is by fetoscopic endoluminal tracheal occlusion. Obstruction of the airways triggers lung growth. This procedure is currently being evaluated in a global clinical trial for left sided cases; right sided cases with poor prognosis are offered the procedure clinically. The search for more potent and less invasive therapies continues. Prenatal transplacental sildenafil administration will in due course be tried clinically, with the aim to reduce the occurrence of persistent pulmonary hypertension, either alone or in combination with fetal surgery. Other medical approaches are in an earlier translational phase.

Original languageEnglish
Pages (from-to)270-280
Number of pages11
JournalMinerva Pediatrica
Volume70
Issue number3
DOIs
Publication statusPublished - 1 Jun 2018

Keywords

  • Congenital
  • Diaphragmatic
  • Fetal therapy
  • Hernias
  • Sildenafil citrate

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