Antenatal Medical Therapies to Improve Lung Development in Congenital Diaphragmatic Hernia

Aidan Kashyap, Philip Dekoninck, Kelly Crossley, Marta Thio, Graeme Polglase, Francesca Maria Russo, Jan Deprest, Stuart Hooper, Ryan Hodges

Research output: Contribution to journalReview ArticleResearchpeer-review

5 Citations (Scopus)

Abstract

Congenital diaphragmatic hernia (CDH) is a birth defect characterized by failed closure of the diaphragm, allowing abdominal viscera to herniate into the thoracic cavity and subsequently impair pulmonary and vascular development. Despite improving standardized postnatal management, there remains a population of severe CDH for whom postnatal care falls short. In these severe cases, antenatal surgical intervention (fetoscopic endoluminal tracheal occlusion [FETO]) may improve survival; however, FETO increases the risk of preterm delivery, is not widely offered, and still fails in half of cases. Antenatal medical therapies that stimulate antenatal pulmonary development are therefore interesting alternatives. By presenting the animal research underpinning novel antenatal medical therapies for CDH, and considering the applications of these therapies to clinical practice, this review will explore the future of antenatal CDH management with a focus on the phosphodiesterase-5 inhibitor sildenafil.

Original languageEnglish
Pages (from-to)823-836
Number of pages14
JournalAmerican Journal of Perinatology
Volume35
Issue number9
DOIs
Publication statusPublished - 1 Jul 2018

Keywords

  • antenatal therapy
  • congenital diaphragmatic hernia
  • fetal
  • pulmonary hypertension of the newborn
  • pulmonary hypoplasia
  • sildenafil

Cite this

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title = "Antenatal Medical Therapies to Improve Lung Development in Congenital Diaphragmatic Hernia",
abstract = "Congenital diaphragmatic hernia (CDH) is a birth defect characterized by failed closure of the diaphragm, allowing abdominal viscera to herniate into the thoracic cavity and subsequently impair pulmonary and vascular development. Despite improving standardized postnatal management, there remains a population of severe CDH for whom postnatal care falls short. In these severe cases, antenatal surgical intervention (fetoscopic endoluminal tracheal occlusion [FETO]) may improve survival; however, FETO increases the risk of preterm delivery, is not widely offered, and still fails in half of cases. Antenatal medical therapies that stimulate antenatal pulmonary development are therefore interesting alternatives. By presenting the animal research underpinning novel antenatal medical therapies for CDH, and considering the applications of these therapies to clinical practice, this review will explore the future of antenatal CDH management with a focus on the phosphodiesterase-5 inhibitor sildenafil.",
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Antenatal Medical Therapies to Improve Lung Development in Congenital Diaphragmatic Hernia. / Kashyap, Aidan; Dekoninck, Philip; Crossley, Kelly; Thio, Marta; Polglase, Graeme; Russo, Francesca Maria; Deprest, Jan; Hooper, Stuart; Hodges, Ryan.

In: American Journal of Perinatology, Vol. 35, No. 9, 01.07.2018, p. 823-836.

Research output: Contribution to journalReview ArticleResearchpeer-review

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AU - Polglase, Graeme

AU - Russo, Francesca Maria

AU - Deprest, Jan

AU - Hooper, Stuart

AU - Hodges, Ryan

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AB - Congenital diaphragmatic hernia (CDH) is a birth defect characterized by failed closure of the diaphragm, allowing abdominal viscera to herniate into the thoracic cavity and subsequently impair pulmonary and vascular development. Despite improving standardized postnatal management, there remains a population of severe CDH for whom postnatal care falls short. In these severe cases, antenatal surgical intervention (fetoscopic endoluminal tracheal occlusion [FETO]) may improve survival; however, FETO increases the risk of preterm delivery, is not widely offered, and still fails in half of cases. Antenatal medical therapies that stimulate antenatal pulmonary development are therefore interesting alternatives. By presenting the animal research underpinning novel antenatal medical therapies for CDH, and considering the applications of these therapies to clinical practice, this review will explore the future of antenatal CDH management with a focus on the phosphodiesterase-5 inhibitor sildenafil.

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