Fetal surgery for congenital diaphragmatic hernia.
Congenital diaphragmatic hernia (CDH) continues to account for significant mortality in neonates. Advances in postnatal therapies have reduced mortality rates in the less severely affected infants, though surviving infants continue to display significant comorbid conditions. The history of fetal treatment for CDH is a microcosm for the development of fetal therapy in general. This paper traces this history from early clinical observations and imaging advances to experimental animal studies and finally to safe human application and development of clinical trails. Encouraging recent results and improved outcomes lend credence to the idea than prenatal interventions may give clinicians and families more hope.
Grethel
Erich J
EJ
Fetal Treatment Center, Department of Surgery, University of California, San Francisco, 94143, USA.
Nobuhara
Kerilyn K
KK
D004065:Digestive System Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D046128:Fetal Therapies / Q000379:methods*; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging / Q000601:surgery*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D011247:Pregnancy; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal