Prenatal diagnosis and management of congenital diaphragmatic hernia

David Basurto, Francesca Maria Russo, Lennart Van der Veeken, Johannes Van der Merwe, Stuart Hooper, Alexandra Benachi, Felix De Bie, Olga Gomez, Jan Deprest

Research output: Contribution to journalReview ArticleResearchpeer-review

41 Citations (Scopus)

Abstract

Congenital diaphragmatic hernia is characterized by failed closure of the diaphragm, thereby allowing abdominal viscera to herniate into the thoracic cavity and subsequently interfering with normal lung development. At birth, pulmonary hypoplasia leads to respiratory insufficiency and persistent pulmonary hypertension (PHT), that is lethal in up to 32% of patients. In isolated cases, the outcome may be predicted prenatally by medical imaging and advanced genetic testing. In those fetuses with a predicted poor outcome, fetoscopic endoluminal tracheal occlusion may be offered. This procedure is currently being evaluated in a global randomized clinical trial (www.TOTALtrial.eu). We are currently investigating alternative strategies including transplacental sildenafil administration to reduce the occurrence of persistent PHT.

Original languageEnglish
Pages (from-to)93-106
Number of pages14
JournalBest Practice and Research: Clinical Obstetrics and Gynaecology
Volume58
DOIs
Publication statusPublished - Jul 2019

Keywords

  • Congenital diaphragmatic hernia
  • Prenatal prediction
  • Prenatal therapy
  • Pulmonary hypoplasia
  • Sildenafil

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