Changing perspectives on the perinatal management of isolated congenital diaphragmatic hernia in Europe.
Congenital diaphragmatic hernia (CDH) should be diagnosed in the prenatal period and prompt referral to a tertiary referral center for imaging, genetic testing, and multidisciplinary counseling. Individual prediction of prognosis is based on the absence of additional anomalies, lung size, and liver herniation. In severe cases, a prenatal endotracheal balloon procedure is currently being offered at specialized centers. Fetal intervention is now also offered to milder cases within a trial, hypothesizing that this may reduce the occurrence of bronchopulmonary dysplasia in survivors. Postnatal management has been standardized by European high-volume centers for the purpose of this and other trials.
Deprest
Jan A
JA
Woman and Child Division, Fetal Medicine Unit, University Hospital Gasthuisberg, Leuven, Belgium. jan.deprest@uzleuven.be
Gratacos
Eduardo
E
Nicolaides
Kypros
K
Done
Elise
E
Van Mieghem
Tim
T
Gucciardo
Leonardo
L
Claus
Filip
F
Debeer
Anne
A
Allegaert
Karel
K
Reiss
Irwin
I
Tibboel
Dick
D
D003952:Diagnostic Imaging / Q000379:methods*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006548:Hernia, Diaphragmatic / Q000175:diagnosis / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D018743:Perinatal Care / Q000639:trends*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D015995:Prevalence