Encouraging early clinical experience with deliberately delayed temporary fetoscopic tracheal occlusion for the prenatal treatment of life-threatening right and left congenital diaphragmatic hernias.
OBJECTIVE
In order to assess the effect of deliberately delayed percutaneous fetoscopic tracheal occlusion on survival of fetuses with life-threatening congenital diaphragmatic hernia.


METHODS
Eight fetuses with life-threatening congenital diaphragmatic hernia underwent fetoscopic tracheal balloon occlusion between 29 + 0 and 32 + 4 weeks of gestation. Delayed occlusion was chosen in order to minimize potentially negative pulmonary effects from premature delivery as a result of fetal surgery. In addition, we wanted to become able to provide all available postnatal intensive care treatment means in these patients.


RESULTS
Six of the 8 fetuses survived to discharge from hospital.


CONCLUSIONS
Delayed fetoscopic tracheal balloon occlusion may be rewarded with lung growth sufficient to allow survival of fetuses with life-threatening congenital diaphragmatic hernia.
Kohl
Thomas
T
German Center for Fetal Surgery and Minimally Invasive Therapy, University Hospital of Bonn, Germany. thomas.kohl@ukb.uni-bonn.de
Gembruch
Ulrich
U
Filsinger
Barbara
B
Hering
Rudolf
R
Bruhn
Jorgen
J
Tchatcheva
Kristina
K
Aryee
Sebastian
S
Franz
Axel
A
Heep
Axel
A
Muller
Andreas
A
Bartmann
Peter
P
Loff
Stefan
S
Hosie
Stuart
S
Neff
Wolfgang
W
Schaible
Thomas
T
D021721:Balloon Occlusion; D005260:Female; D005315:Fetal Diseases / Q000601:surgery*; D005332:Fetoscopy; D005865:Gestational Age; D006548:Hernia, Diaphragmatic / Q000601:surgery*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D011247:Pregnancy; D013997:Time Factors; D014132:Trachea; D016216:Ultrasonography, Prenatal