Congenital Diaphragmatic hernia

A congenital diaphragmatic hernia (CDH) is a potentially life-threatening birth defect.

The diaphragm is a shelf of muscle that separates the chest from the abdomen but in babies with CDH it either fails to fuse, resulting in a hole; or doesn’t develop at all. This means that the contents of the abdomen – including the stomach, intestines, liver and spleen – may protrude into your baby’s chest. This prevents one or both lungs from developing normally, which means your baby may have difficulty breathing after he’s born.

Many cases of CDH are spotted during the second trimester scan and you may be referred for a fetal MRI to diagnose the condition. If your baby’s CDH isn’t detected during your pregnancy he’ll show symptoms soon after he’s born – these may include difficulty breathing, rapid breathing and heart rate, one side of his chest being larger than the other, and a depression in his abdomen. A chest X-ray will confirm the diagnosis and an ultrasound may be carried out to check your baby’s heart.

Treatment

If CDH is diagnosed prenatally a detailed plan will be drawn up for your baby’s delivery and aftercare. The condition will be treated as a pediatric emergency because your baby will be born with breathing difficulties, so you may have to deliver at a hospital with a neonatal intensive care unit. If his condition is serious, your newborn may need to be placed on a temporary heart/lung bypass system. Once he stabilizes, he’ll have surgery to move his displaced organs back into his abdominal cavity and either repair the hole is in his diaphragm or construct an artificial one.

After the surgery your baby’s lungs will still be underdeveloped so he’ll likely need breathing support from a ventilator. Once he’s well enough to come off it he may still need oxygen and medication to assist with his breathing. As far as his long-term recovery is concerned, your baby may suffer from gastroesophegal reflux, and his physical strength and co-ordination may not develop as fast as other children.

The information on this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.