Skip to main content
Top
Published in: Pediatric Surgery International 4/2020

01-04-2020 | Diaphragmatic Hernia | Review Article

Congenital diaphragmatic hernia: current management strategies from antenatal diagnosis to long-term follow-up

Authors: Eimear Kirby, Richard Keijzer

Published in: Pediatric Surgery International | Issue 4/2020

Login to get access

Abstract

Congenital diaphragmatic hernia (CDH) is a developmental birth defect consisting of a diaphragmatic defect and abnormal lung development. CDH complicates 2.3–2.8 per 10,000 live births. Despite efforts to standardize clinical practice, management of CDH remains challenging. Frequent re-evaluation of clinical practices in CDH reveals that management of CDH is evolving from one of postnatal stabilization to prenatal optimization. Translational research reveals promising avenues for in utero therapeutic intervention, including fetoscopic endoluminal tracheal occlusion. These remain highly experimental and demand improved antenatal diagnostics. Timely diagnosis of CDH and identification of severely affected fetuses allow time for delivery planning or in utero therapeutics. Optimal perinatal care and surgical treatment strategies are highly debated. Improved CDH mortality rates have placed increased emphasis on identifying and monitoring the long-term sequelae of disease throughout childhood and into adulthood. We review the current management strategies for CDH, highlighting where progress has been made, and where future developments have the potential to revolutionize care in this vulnerable patient population.
Literature
13.
go back to reference Moore KL, Persaud TVN, Torchia MG (2008) The developing human: clinically oriented embryology, 8th edn. Saunders/Elsevier, New York Moore KL, Persaud TVN, Torchia MG (2008) The developing human: clinically oriented embryology, 8th edn. Saunders/Elsevier, New York
32.
go back to reference Hidaka N, Murata M, Sasahara J et al (2015) Correlation between lung to thorax transverse area ratio and observed/expected lung area to head circumference ratio in fetuses with left-sided diaphragmatic hernia. Congenit Anom (Kyoto) 55:81–84. https://doi.org/10.1111/cga.12092 CrossRef Hidaka N, Murata M, Sasahara J et al (2015) Correlation between lung to thorax transverse area ratio and observed/expected lung area to head circumference ratio in fetuses with left-sided diaphragmatic hernia. Congenit Anom (Kyoto) 55:81–84. https://​doi.​org/​10.​1111/​cga.​12092 CrossRef
40.
go back to reference Russo FM, Cordier A-G, De Catte L et al (2018) Proposal for standardized prenatal ultrasound assessment of the fetus with congenital diaphragmatic hernia by the European reference network on rare inherited and congenital anomalies (ERNICA). Prenat Diagn 38:629–637. https://doi.org/10.1002/pd.5297 CrossRefPubMed Russo FM, Cordier A-G, De Catte L et al (2018) Proposal for standardized prenatal ultrasound assessment of the fetus with congenital diaphragmatic hernia by the European reference network on rare inherited and congenital anomalies (ERNICA). Prenat Diagn 38:629–637. https://​doi.​org/​10.​1002/​pd.​5297 CrossRefPubMed
45.
go back to reference Beurskens LWJE, Schrijver LH, Tibboel D et al (2013) Dietary vitamin A intake below the recommended daily intake during pregnancy and the risk of congenital diaphragmatic hernia in the offspring. Birth Defects Res Part A Clin Mol Teratol 97:60–66. https://doi.org/10.1002/bdra.23093 CrossRef Beurskens LWJE, Schrijver LH, Tibboel D et al (2013) Dietary vitamin A intake below the recommended daily intake during pregnancy and the risk of congenital diaphragmatic hernia in the offspring. Birth Defects Res Part A Clin Mol Teratol 97:60–66. https://​doi.​org/​10.​1002/​bdra.​23093 CrossRef
48.
go back to reference Mitchell SJ, Cole T, Redford HA (1997) Congenital diaphragmatic hernia with probable autosomal recessive inheritance in an extended consanguineous Pakistani pedigree. J Med Genet 34:601–603CrossRefPubMedPubMedCentral Mitchell SJ, Cole T, Redford HA (1997) Congenital diaphragmatic hernia with probable autosomal recessive inheritance in an extended consanguineous Pakistani pedigree. J Med Genet 34:601–603CrossRefPubMedPubMedCentral
49.
go back to reference Kufeji DI, Crabbe DCG (1999) Familial bilateral congenital diaphragmatic hernia. Pediatr Surg Int 15:58–60CrossRefPubMed Kufeji DI, Crabbe DCG (1999) Familial bilateral congenital diaphragmatic hernia. Pediatr Surg Int 15:58–60CrossRefPubMed
95.
go back to reference American Heart Association AH, Vardis R (2006) 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support. Pediatrics 117:e989–1004. https://doi.org/10.1542/peds.2006-0219 CrossRef American Heart Association AH, Vardis R (2006) 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support. Pediatrics 117:e989–1004. https://​doi.​org/​10.​1542/​peds.​2006-0219 CrossRef
116.
go back to reference Chatziioannidis I, Mouravas V, Babatseva E (2014) When is the appropriate timing of surgical repair for congenital diaphragmatic hernia? Hippokratia 18:381PubMedPubMedCentral Chatziioannidis I, Mouravas V, Babatseva E (2014) When is the appropriate timing of surgical repair for congenital diaphragmatic hernia? Hippokratia 18:381PubMedPubMedCentral
132.
go back to reference Paré A (1575) Les oeuvres de M. Ambroise Paré conseiller, et premier chirurgien du Roy. Gabriel Buon, Paris Paré A (1575) Les oeuvres de M. Ambroise Paré conseiller, et premier chirurgien du Roy. Gabriel Buon, Paris
134.
go back to reference Irish MS, Holm BA, Glick PL (1996) Congenital diaphragmatic hernia: a historical review. Clin Perinatol 23:625–653CrossRefPubMed Irish MS, Holm BA, Glick PL (1996) Congenital diaphragmatic hernia: a historical review. Clin Perinatol 23:625–653CrossRefPubMed
136.
go back to reference Morgagni GB (1769) The Seats and Causes of Diseases investigated by anatomy (translated from the Latin by Benjamin Alexander, M.D.). In: Millar A, Cadell T (eds.) Book III, 2nd edn. London Morgagni GB (1769) The Seats and Causes of Diseases investigated by anatomy (translated from the Latin by Benjamin Alexander, M.D.). In: Millar A, Cadell T (eds.) Book III, 2nd edn. London
137.
go back to reference Cooper A (1827) The anatomy and surgical treatment of abdominal hernia. Longman, Rees, Orme, Brown & Green, London Cooper A (1827) The anatomy and surgical treatment of abdominal hernia. Longman, Rees, Orme, Brown & Green, London
138.
go back to reference Nyhus H (1964) Hernia. Lippincott, Philadelphia, pp 602–619 Nyhus H (1964) Hernia. Lippincott, Philadelphia, pp 602–619
139.
go back to reference Bochdalek V (1848) Einige Betrachtungen uber die Entstehung des angeborenen Zwerchfellbruches: Als Beitrag zur pathologischen Anatomie der Hernien. Wochenschr Prakt Heilk 19:89–97 Bochdalek V (1848) Einige Betrachtungen uber die Entstehung des angeborenen Zwerchfellbruches: Als Beitrag zur pathologischen Anatomie der Hernien. Wochenschr Prakt Heilk 19:89–97
140.
go back to reference Heidenhain L (1905) Geschichte eines Falles von chronischer Incarceration des Magens in einer angeborenen Zwerchfellhernie welcher durch Laparotomie geheilt wurde mit anschliessenden Bemerkungen tiber die Möglichkeit das Kardiacarcinom der Speiseröhre zu resesziren. Deutsch Z Chir 394–403 Heidenhain L (1905) Geschichte eines Falles von chronischer Incarceration des Magens in einer angeborenen Zwerchfellhernie welcher durch Laparotomie geheilt wurde mit anschliessenden Bemerkungen tiber die Möglichkeit das Kardiacarcinom der Speiseröhre zu resesziren. Deutsch Z Chir 394–403
143.
go back to reference Korns HM (1921) The diagnosis of “Eventration” of diaphragm. Arch Int Med 28(2):192–212CrossRef Korns HM (1921) The diagnosis of “Eventration” of diaphragm. Arch Int Med 28(2):192–212CrossRef
144.
go back to reference Gross RE (1946) Congenital hernia of the diaphragm. Am J Dis Child 71:579–592 Gross RE (1946) Congenital hernia of the diaphragm. Am J Dis Child 71:579–592
146.
go back to reference de Lorimier A, Tierney D, Parker H (1967) Hypoplastic lungs in fetal lambs with surgically produced diaphragmatic hernia. Surgery 62:12–17 de Lorimier A, Tierney D, Parker H (1967) Hypoplastic lungs in fetal lambs with surgically produced diaphragmatic hernia. Surgery 62:12–17
149.
go back to reference Bartlett RH, Gazzaniga AB, Jefferies MR et al (1976) Extracorporeal membrane oxygenation (ECMO) cardiopulmonary support in infancy. Trans Am Soc Artif Intern Organs 22:80–93PubMed Bartlett RH, Gazzaniga AB, Jefferies MR et al (1976) Extracorporeal membrane oxygenation (ECMO) cardiopulmonary support in infancy. Trans Am Soc Artif Intern Organs 22:80–93PubMed
150.
go back to reference Bell MJ, Trenberg JL (1977) Antenatal diagnosis of diaphragmatic hernia. Pediatrics 60:738–740PubMed Bell MJ, Trenberg JL (1977) Antenatal diagnosis of diaphragmatic hernia. Pediatrics 60:738–740PubMed
152.
go back to reference Harrison MR, Jester JA, Ross NA (1980) Correction of congenital diaphragmatic hernia in utero. I. The model: intrathoracic balloon produces fatal pulmonary hypoplasia. Surgery 88:174–182PubMed Harrison MR, Jester JA, Ross NA (1980) Correction of congenital diaphragmatic hernia in utero. I. The model: intrathoracic balloon produces fatal pulmonary hypoplasia. Surgery 88:174–182PubMed
Metadata
Title
Congenital diaphragmatic hernia: current management strategies from antenatal diagnosis to long-term follow-up
Authors
Eimear Kirby
Richard Keijzer
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 4/2020
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-020-04625-z

Other articles of this Issue 4/2020

Pediatric Surgery International 4/2020 Go to the issue