Advances in prenatal diagnosis and treatment of congenital diaphragmatic hernia.
Congenital diaphragmatic hernia (CDH) is a common birth anomaly. Absence or presence of liver herniation and determination of lung-to-head ratio are the most accurate predictors of prognosis for fetuses with CDH. Though open fetal CDH repair has been abandoned, fetal endoscopic balloon tracheal occlusion promotes lung growth in fetuses with severe CDH. Although significant improvements in lung function have not yet been shown in humans, reversible or dynamic tracheal occlusion is promising for select fetuses with severe CDH. This article reviews advances in prenatal diagnosis of CDH, the experimental basis for tracheal occlusion, and its translation into human clinical trials.
Division of Pediatric Surgery, Department of Surgery, Fetal Treatment Center University of California, San Francisco, 513 Parnassus Avenue, HSW-1601, San Francisco, CA 94143-0570, USA.
Eveline H
EH
Shue
Doug
D
Miniati
Hanmin
H
Lee
D021721:Balloon Occlusion / Q000379:methods*; D005260:Female; D005332:Fetoscopy / Q000379:methods*; D006548:Hernia, Diaphragmatic / Q000175:diagnosis / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D014132:Trachea / Q000000981:diagnostic imaging* / Q000601:surgery; D016216:Ultrasonography, Prenatal